Health Equity & Access Weekly Roundup: December 15, 2024

Unmet Needs in Hemophilia: Prophylaxis, Bleeding, Quality of Life

Two studies presented at the 2024 American Society of Hematology (ASH) Annual Meeting underscore significant unmet needs in hemophilia care despite advances in prophylactic therapies. Persistent issues include bleeding episodes, joint damage, and diminished quality of life (QoL) for many patients, as shown by data from surveys and real-world studies involving individuals with hemophilia A (HA) and hemophilia B (HB). While therapies like standard and extended half-life factor replacement and non-factor treatments have reduced annual bleeding rates (ABRs), 16% of patients still experienced bleeds, with joint problems reported in 25% of cases.

Your Home, Your Health: The Hidden Costs of Housing Insecurity

Instability, such as frequent moves or homelessness, is linked to chronic health issues, mental health challenges, and increased mortality, particularly among vulnerable groups like children, pregnant women, and minority populations. Poor housing quality exposes residents to hazards like lead, mold, and overcrowding, leading to chronic diseases and injuries, while affordability issues force many families into financial strain, homelessness, or unsafe living conditions. Neighborhood factors, including access to nutritious food, safe spaces, and transportation, further shape health outcomes, with systemic policies like redlining exacerbating disparities. Stakeholders across sectors are urged to develop innovative policies to address the interconnected health and housing challenges and promote equitable access to healthy living environments.

Small Firms, Big Costs: Employer Health Coverage Disparities

A new report from The Commonwealth Fund highlights the growing financial burden faced by workers at small businesses in maintaining health insurance coverage compared to their counterparts at large firms. Despite small businesses outnumbering large firms, only 49.2% of small-firm employees are offered employer-sponsored insurance (ESI) compared with 97.6% at large firms, with small-firm employees paying higher premiums and deductibles on average. In 2023, small-firm workers paid 10.8% more in family premiums and 43.1% higher deductibles than those at large firms. Notably, the report reveals significant state-level variations in premiums, reflecting differences in coverage generosity and administrative costs between firm sizes. With employer-sponsored insurance covering 63% of working adults, these disparities underscore broader challenges in the US health care system's affordability and equity.

Confronting Systemic Racial Inequities in Health Care Data Must Start With Employers

Robin Glasgow, MBA, executive leadership advisor at Spencer Stuart, underscores the critical role of data in addressing health equity, emphasizing the need to confront inherent biases in data collection and algorithms. Drawing on her 30 years of experience and personal encounters with biased care, Glasgow advocates for human-centered innovation that prioritizes underserved populations to create solutions benefiting all. Speaking at the Coalition for Affordable Quality Healthcare (CAQH) Connect conference, she highlighted the challenges posed by systemic and human-created biases in health care data and algorithms, stressing the importance of leadership in driving equitable transformation. Glasgow proposes a three-step approach: acknowledging bias, committing to courageous actions, and embedding health equity into an organization’s mission.

Uncovering Factors Driving Survival in Hawaiian/Pacific Islander, Asian Indian/Pakistani Patients With Ovarian Cancer

In part 2 of her interview, Alice W. Lee, PhD, MPH, of California State University, Fullerton, discusses disparities in ovarian cancer outcomes, noting that Hawaiian/Pacific Islander patients experience the poorest survival rates while Asian Indian/Pakistani patients have the highest. Although her study, based on cancer registry data, lacked behavioral and lifestyle details, Lee suggests that factors such as higher smoking rates and BMI among Hawaiian/Pacific Islanders and lower tobacco use among Asian Indian/Pakistanis may contribute to these outcomes. She emphasizes the multifactorial nature of survival and advocates for further research to uncover underlying causes, particularly through deeper exploration of Hawaiian/Pacific Islander populations and disaggregation of ethnic subgroups to better understand their unique risk factors.