Health Equity & Access Weekly Roundup: October 5, 2024

Corporate Accountability and Public Health: Sackler Ruling and Treatment Gaps in the Opioid Crisis

The US Supreme Court's decision to revoke the Sackler family's immunity from opioid-related lawsuits marks a turning point in corporate accountability during public health crises. This ruling, which overturns a prior bankruptcy court settlement, allows for renewed litigation against the Sacklers for their role in the opioid epidemic. Meanwhile, a new report from the Office of Inspector General exposes critical gaps in access to opioid use disorder treatment, particularly for Medicare and Medicaid enrollees, exacerbating the ongoing public health crisis. Addressing these treatment access challenges remains an urgent priority as legal action progresses.

Optimizing GDMT Could Prevent Over 1 Million HFrEF Deaths Annually

A recent study in JAMA Cardiology reveals a global underutilization of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF), which could prevent over a million deaths annually. Based on data from nearly 30 million patients with HFrEF, the research highlights significant gaps in the use of life-saving medications, particularly in low- and middle-income countries. Optimizing GDMT use could prevent 1.2 million global deaths, especially in Southeast Asia and the Western Pacific. The study emphasizes the need for better implementation of GDMT, addressing disparities in treatment access, and removing barriers to care to improve patient outcomes worldwide.

The Health-Related Consequences of Redlining

Historic redlining has long-lasting impacts on health outcomes by suppressing economic opportunity and access to care. Minority populations in redlined areas face greater risks of fatal diseases, pregnancy complications, HIV, and asthma exacerbations worsened by environmental hazards, industrial pollution, and stress. To address these disparities, policy makers must prioritize investments in housing, education, health care access, and economic empowerment alongside policies targeting environmental and social factors in historically redlined areas. Comprehensive interventions are essential to mitigate the ongoing effects of redlining and improve health equity for affected populations.

Association Between Hypertensive Disorders of Pregnancy, Cardiovascular Severe Maternal Morbidity During Delivery Hospitalization

A study of over 15 million US deliveries found that hypertensive disorders of pregnancy (HDP), particularly HELLP syndrome and severe preeclampsia, are strongly associated with increased risks of cardiovascular severe maternal morbidity (cvSMM). HELLP syndrome posed the highest risk, followed by severe preeclampsia and chronic hypertension. Cardiovascular complications like pulmonary edema and stroke were more prevalent in patients with HDP during delivery. While the study highlighted significant cardiovascular risks linked to HDP, it also acknowledged limitations related to data collection and potential misclassification. These findings stress the importance of targeted cardiovascular interventions for pregnant individuals with HDP, especially those with HELLP syndrome.

Expansion of Certified Community Behavioral Health Clinics Increases Access to Mental Health

The expansion of Certified Community Behavioral Health Clinics (CCBHCs) has significantly increased access to mental health and substance use disorder care, now serving over half of the US population. These federally funded clinics, which provide comprehensive care regardless of ability to pay, have grown rapidly since their 2016 inception, expanding from just 1.53% of counties to nearly 40% by mid-2024. The study highlights geographic disparities in CCBHC access, with rural and underserved areas remaining less covered. While Medicaid- and Substance Abuse and Mental Health Services Administration–funded CCBHCs have improved care access for millions, further efforts are needed to ensure equitable distribution of services across the country.