Health Equity & Access Weekly Roundup: June 19, 2026

Texas Abortion Ban Linked to Worsening Maternal Mental Health

The proportion of Texas mothers reporting fair or poor mental health nearly doubled after the state's 2021 ban took effect, rising from 4.6% to 9.3%, compared with a smaller increase, from 5.4% to 7.5%, in the comparison states. A difference-in-differences analysis using National Survey of Children's Health data from 2016 to 2023 compared more than 4300 reproductive-age mothers in Texas with more than 152,000 mothers across 29 states that had not enacted similar bans. After adjustment, researchers found a statistically significant 2.52 percentage-point excess increase in Texas, with the effect more than doubling among mothers whose children were covered by Medicaid or the Children's Health Insurance Program. The authors are calling for expanded mental health screening integrated into routine prenatal and postpartum care, regardless of whether a patient is seeking abortion services.

Trial Eligibility Requirements Capture Only a Fraction of Adults With Sickle Cell Disease: Julie Kanter, MD

Current clinical trial eligibility criteria for new sickle cell disease (SCD) therapies capture only a small share of the adults living with the condition, according to data Julie Kanter, MD, of the University of Alabama at Birmingham, presented at the European Hematology Association 2026 Congress. Using 3 linked national data sources, including the GRNDaD registry, the CDC's Sickle Cell Data Collection program, and an American Society of Hematology data hub, Kanter's team started with 456 adults and sequentially applied standard trial exclusion criteria, narrowing the eligible cohort to about 160 patients. Requiring 2 to 10 or 2 to 12 documented pain crises in the prior year cut that number further, to just 45 patients, or 9.9% of the original population. Kanter said the findings show SCD remains underserved by drug development, with new therapies designed for and tested in only a narrow slice of the broader patient population. She called for more individualized post-authorization monitoring once approved drugs reach the wider SCD population, noting that any therapy carries added uncertainty when extended beyond such a constrained trial cohort.

Representation Gaps Undermine Nutrition Guidelines' Impact: Hollie Raynor, PhD, RD, LD

The US Healthy Eating Index has stayed roughly flat, between average scores of 55 and 60, since 2005, a stagnation that Hollie Raynor, PhD, RD, LD, a member of the 2025 Dietary Guidelines Advisory Committee, attributes to gaps in the evidence base itself rather than a failure of nutrition science. Speaking at the American Diabetes Association 2026 Scientific Sessions, Raynor said her committee's review repeatedly found homogeneous study samples and inconsistent demographic reporting, with variables like household food insecurity largely absent from the literature unless they were the primary research question. In a follow-up interview, Raynor argued that guidelines built on a research base unrepresentative of the patients clinicians actually see will always underperform in practice. She called for more purposeful, adequately budgeted recruitment of diverse populations in future nutrition research, alongside a patient-centered, shared decision-making approach when clinicians apply population-level guidelines to individual care.

Health Care Is Fixable: Workers’ Compensation Shows Employers Don’t Need to Wait for Washington

Robert Andrews, CEO of the Healthcare Transformation Alliance, points to workers' compensation as evidence that health care costs can fall without sacrificing outcomes. Real per-capita workers' comp costs have dropped more than 40% since 1990, from $512 to $299, even as workplace injuries declined, whereas self-insured health plan costs over the same period more than doubled, from $6200 to $15,500 per capita, without comparable improvement in outcomes. Andrews attributes the divergence to incentive design. Workers' comp rewards prevention and recovery outcomes, whereas health care still largely rewards volume of services. Andrews outlines a market-driven, ERISA-based playbook for self-insured employers: workers' comp-style capital mandates and audits, private catastrophic risk pools, Centers of Excellence for conditions like musculoskeletal care and high-risk maternity, and clearer claims reporting. He cites results already achieved within the Healthcare Transformation Alliance's 80-plus member cooperative, including 15% to 20% cuts in specialty-drug costs through bulk purchasing and spending growth held below 3%, against an 8% industry average.

Misinformation, Access Gaps Threaten Hepatitis B Elimination Goals

Infant vaccination has driven a 99% reduction in pediatric hepatitis B virus (HBV) infections, but chronic adult disease remains a major unmet challenge, compounded by a December 2025 shift in CDC guidance allowing shared clinical decision-making, rather than universal recommendation, on the newborn birth dose. A cross-sectional study in JAMA Network Open, drawing on data from roughly 75.2 million patients across 56 health systems, found that only about 25% of treatment-eligible US adults with chronic HBV actually receive therapy, with lower treatment odds among Black patients and women of reproductive age. Helen Nde, MPH, of the Center for Disease Analysis Foundation, said misinformation and access barriers, including the burden of lifelong daily antivirals and recurring monitoring, are the central obstacles to closing that gap. She called education at the patient, provider, and systems level the most important lever for progress, noting that chronic HBV carries a 10% to 25% lifetime risk of liver cancer and that the disease still kills more than 800,000 people globally each year.