17 results match your criteria: "Center for Health Equity and Social Justice[Affiliation]"

Co-Morbidity Differences Associated With Long-Term Amputation and Repeat Revascularization Rates After Femoropopliteal Artery Intervention for Intermittent Claudication by Sex, Race, and Ethnicity.

Am J Cardiol

September 2024

Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut.

Use of peripheral vascular intervention (PVI) for intermittent claudication (IC) continues to expand, but there is uncertainty whether baseline demographics, procedural techniques and outcomes differ by sex, race, and ethnicity. This study aimed to examine amputation and revascularization rates up to 4 years after femoropopliteal (FP) PVI for IC by sex, race, and ethnicity. Patients who underwent FP PVI for IC between 2016 and 2020 from the PINC AI Healthcare Database were analyzed.

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Article Synopsis
  • The underutilization of guideline-directed medical therapy for heart failure with reduced ejection fraction among American Indian patients is linked to limited access to cardiology care, particularly in the Navajo Nation.
  • The study aimed to evaluate whether a telehealth model could enhance the use of guideline-directed medical therapy by initiating and adjusting treatment over the phone while using remote monitoring tools.
  • The Hózhó randomized clinical trial involved 103 patients and sought to measure the increase in the number of prescribed drug classes within 30 days after randomization, revealing important insights into the effectiveness of telehealth in improving heart failure management.
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Cardiovascular Disease Burden and Outcomes Among American Indian and Alaska Native Medicare Beneficiaries.

JAMA Netw Open

September 2023

Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, Cardiovascular Institute, University of Pennsylvania, Philadelphia.

Article Synopsis
  • * A study analyzed Medicare data from 2015 to 2019 to evaluate the incidence, prevalence, and mortality of various heart conditions among American Indian and Alaska Native patients aged 65 and older.
  • * Among the 220,598 participants, high rates of diabetes (44.8%), hyperlipidemia (61.3%), and hypertension (72.2%) were found, with evidence of worsening heart health indicators, such as an increase in myocardial infarction rates and consistent prevalence of coronary artery disease over the study period.
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Racial Differences in Presentation and Outcomes After Peripheral Arterial Interventions: Insights From the NCDR-PVI Registry.

Circ Cardiovasc Interv

June 2023

Penn Cardiovascular Outcomes, Quality & Evaluative Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia (H.M.J., L.A.E., G.J.W., A.S.N., A.C.F., S.A.M.K., P.G., T.K., J.G.).

Article Synopsis
  • The study analyzed the use of medical devices and outcomes related to lower extremity peripheral arterial interventions for different racial groups using data from the American College of Cardiology National Cardiovascular Data Registry from 2014 to 2019.
  • It found that while Black patients had higher rates of specific health conditions and socio-economic challenges, they received drug-eluting technologies more often than White patients, but there were no significant differences in the use of atherectomy or intravascular imaging.
  • Interestingly, Black patients were less likely to undergo surgical or repeat procedures after 1 year, although there were no differences in mortality or major amputations between the groups.
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  • The prevalence of Type 2 diabetes and heart failure in the U.S. is increasing, and while GLP-1 receptor agonists and SGLT2 inhibitors help improve patient outcomes, high medication costs may lead to lower adherence to these treatments.
  • This study examined the impact of prescription co-payment levels on adherence to GLP-1 and SGLT2 therapies over one year, using data from individuals with T2D and/or heart failure who had prescription claims from early 2014 to late 2020.
  • Results showed that individuals facing medium or high co-pays were significantly less likely to adhere to their medication regimen, with only 65.3% of GLP-1 users and
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  • Postpartum cardiovascular evaluations for women with preeclampsia are crucial for managing risk factors that could lead to long-term heart issues, yet many patients miss in-person follow-up visits.
  • A study compared completion rates for postpartum hypertension management via telemedicine versus traditional in-person visits, finding a 32% completion rate for in-person visits compared to 70% for telemedicine.
  • The results showed that younger and Black women were less likely to attend in-person visits, suggesting telemedicine could be a more effective way to reach and manage care for these at-risk populations.
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Importance: Randomized clinical trials have shown that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) cause significant weight loss and reduce cardiovascular events in patients with type 2 diabetes (T2D). Black patients have a disproportionate burden of obesity and cardiovascular disease and have a higher rate of cardiovascular-related mortality. Racial and ethnic disparities in health outcomes are largely attributable to the pervasiveness of structural racism, and patients who are marginalized by racism have less access to novel therapeutics.

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Background Violent crime has recently increased in many major metropolitan cities in the United States. Prior studies suggest an association between neighborhood crime levels and cardiovascular disease, but many have been limited by cross-sectional designs. We investigated whether longitudinal changes in violent crime rates are associated with changes in cardiovascular mortality rates at the community level in one large US city-Chicago, IL.

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Predictors of telemedicine use during the COVID-19 pandemic in the United States-an analysis of a national electronic medical record database.

PLoS One

July 2022

Penn Cardiovascular Outcomes, Quality, & Evaluative Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.

Article Synopsis
  • Telemedicine use surged in the U.S. during the COVID-19 pandemic, but access disparities among disadvantaged groups raised concerns due to limited studies.
  • A retrospective analysis of data from over 1.9 million patients revealed only 21.6% engaged in telemedicine from March to December 2020, indicating significant variability in access.
  • Factors influencing telemedicine utilization included lower odds for older patients and non-Hispanic Black individuals, while female gender and Hispanic ethnicity increased the odds, highlighting ongoing inequalities in access to telehealth services.
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A modern approach to mitigating the impact of cardiovascular disease on Americans demands not only an understanding of modifiable conditions that contribute to its development but also a greater appreciation of the heterogeneous distribution of these conditions based on race. As race is not a biological construct, further research is needed to fully elucidate the mechanisms that contribute to these differences. The consequences of the differential impact of modifiable risk factors on cardiovascular disease outcomes among black Americans compared with white Americans cannot be understated.

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This pilot randomized clinical trial evaluates the increased uptake and acceptability of a text-based model for home blood pressure monitoring compared with online portal use among Black patients with Medicaid and Medicare insurance who have hypertension and cardiovascular disease.

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Weaving Antiracism Practice and Equity Into the Fabric of Cardiovascular Fellowship: A New Training Paradigm.

J Am Coll Cardiol

December 2021

Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Center for Cardiovascular Outcomes, Quality, and Evaluative Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Penn Cardiovascular Center for Health Equity and Social Justice, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Leonard Davis Institute of Health Economics at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address: https://twitter.com/sri_adu.

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Importance: Sodium-glucose cotransporter 2 (SGLT2) inhibitors significantly reduce deaths from cardiovascular conditions, hospitalizations for heart failure, and progression of kidney disease among patients with type 2 diabetes. Black individuals have a disproportionate burden of cardiovascular and chronic kidney disease (CKD). Adoption of novel therapeutics has been slower among Black and female patients and among patients with low socioeconomic status than among White or male patients or patients with higher socioeconomic status.

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Importance: In patients with paroxysmal atrial fibrillation (AF), rhythm control with either antiarrhythmic drugs (AADs) or catheter ablation has been associated with decreased symptoms, prevention of adverse remodeling, and improved cardiovascular outcomes. Adoption of advanced cardiovascular therapeutics, however, is often slower among patients from racial/ethnic minority groups and those with lower income.

Objective: To ascertain the cumulative rates of AAD and catheter ablation use for the management of paroxysmal AF and to investigate for the presence of inequities in AF management by evaluating the association of race/ethnicity and socioeconomic status with their use in the United States.

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Importance: The coronavirus disease 2019 (COVID-19) pandemic has required a shift in health care delivery platforms, necessitating a new reliance on telemedicine.

Objective: To evaluate whether inequities are present in telemedicine use and video visit use for telemedicine visits during the COVID-19 pandemic.

Design, Setting, And Participants: In this cohort study, a retrospective medical record review was conducted from March 16 to May 11, 2020, of all patients scheduled for telemedicine visits in primary care and specialty ambulatory clinics at a large academic health system.

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The Boston Public Health Commission's Center for Health Equity and Social Justice provides grant funding, training, and technical assistance to 15 organizations and coalitions across New England to develop, implement, and evaluate community-based policy and systems change strategies that address social determinants of health and reduce racial and ethnic health inequities. This article describes Boston Public Health Commission's health equity framework, theory of change regarding the elimination of racial and ethnic health inequities, and current grantmaking model. To conclude, the authors evaluate the grant model and offer lessons learned from providing multiyear regional grants to promote health equity.

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