Health Equity & Access Weekly Roundup: February 17, 2025

Systemic Solutions to Improve Telehealth Access for Non-English Speakers

Systemic barriers that limit video-based telehealth access for non–English language preference patients were highlighted in a new study. Based on interviews with Spanish- and Cantonese-speaking adults, the researchers found that communication challenges, technical difficulties, and inadequate interpretation services hinder equitable telehealth use. Many participants struggled with video visit platforms, digital literacy, and the lack of language-concordant support despite recognizing telehealth's convenience for routine care. Experts proposed the Translation, Education, Concordant Care, Community Outreach, and Interpretation framework, advocating for improved translation, education, interpretation, and community outreach to address disparities.

Abortion Bans Linked to Higher Infant Mortality, Disproportionately Impact Black Infants

Higher-than-expected infant mortality rates were observed in states enforcing complete or 6-week abortion bans, with the greatest increases among Black infants and deaths due to congenital anomalies, according to an investigation. Researchers estimated 478 excess infant deaths across 14 states with bans, with a 5.6% overall rise in mortality and a 10.98% increase among non-Hispanic Black infants. The impact was most pronounced in southern states, particularly Texas. The researchers indicated that abortion bans may worsen existing racial disparities in infant health, though limitations include state-level variations and provisional 2023 data.

ACS’ Dahut on Finding Cancer Before It Starts and Funding Researchers as They Start

In his keynote address at the American Society of Clinical Oncology Genitourinary Cancers Symposium (ASCO GU), William Dahut, MD, chief scientific officer of the American Cancer Society (ACS), reinforced the organization's commitment to discovery, advocacy, and patient support. ACS funds $517 million in research grants, prioritizing early-career investigators and diversity in science. Its advocacy efforts include lobbying for legislative support, such as the multi-cancer detection bill, while patient services span 20,000 community sites offering lodging, transportation, and survivorship programs. Dahut outlined ACS' research pillars, including accelerating cancer understanding, improving patient outcomes, and investing in future scientists. He emphasized ACS’ focus on prostate cancer, particularly in high-risk Black men, and the importance of equitable clinical trials. Artificial intelligence's (AI) role in early detection was also discussed. The address underscored ACS' patient-centered approach and willingness to collaborate to improve care access and efficiency.

“Expanding Access Isn’t Just About Fairness—It’s About Building Better Treatments for Everyone”

Global clinical trials remain heavily concentrated in wealthy countries despite the strong link between poverty and worse outcomes in diseases like renal cell carcinoma. At the ASCO GU symposium, Regina Barragan-Carrillo, MD, highlighted that 76% of RCC trials occur in high-income countries, with none in low-income regions, leading to gaps in understanding drug effectiveness and delivery in diverse settings. She emphasized the need for governments, nongovernmental organizations, and pharmaceutical companies to collaborate in funding trials beyond profit-driven motives. Expanding global trial access would not only enhance fairness but also improve treatment efficacy, reduce costs, and strengthen health care systems worldwide. However, recent US policy shifts, including cuts to global health funding, threaten to further limit equity in cancer research and treatment.

Addressing Financial Toxicity and Clinical Trial Disparities in Community Oncology

At a November 2024 Institute for Value-Based Medicine event, Susan Escudier, MD, FACP, discussed how social determinants of health exacerbate cancer care disparities in Houston, Texas, and how community oncology practices can help mitigate these challenges. She highlighted the role of financial assistance programs, such as foundation support and rebate cards, in addressing financial toxicity, though she noted the fragmented nature of these resources. To improve clinical trial access for underserved populations, Texas Oncology has expanded trials to rural clinics and emphasized community engagement strategies tailored to local populations, recognizing that effective outreach varies by region.