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The top articles of 2023 addressed key issues such as representation gaps in aRCC research, concerns about the 340B program's impact on asthma disparities, slow adoption of equity innovations, potential biases in type 2 diabetes risk models, and addressing disparities in psoriasis treatment based on race and culture.
This year, the most-read coverage on the Center on Health Equity and Access explored key health equity issues, including representation gaps in advanced renal cell carcinoma (aRCC) research, concerns about the 340B program's impact on chronic asthma disparities, the slow adoption of equity innovations, potential racial biases in type 2 diabetes risk models, and considerations for addressing disparities in psoriasis treatment based on race and culture.
For more from the Center on Health Equity and Access read the rest of our coverage.
5. Age, Race, and Ethnicity Representation Disparities Found in Patients Participating in aRCC Research
Representation disparities exist among patients with advanced renal cell carcinoma (aRCC) in research, with age, race, and ethnicity variations revealed in real-world evidence (RWE), randomized controlled trials (RCTs), and Surveillance, Epidemiology, and End Results (SEER) data. Results showed RCT participants were younger at metastatic diagnosis compared with those in RWE and SEER, and Black and Hispanic patients had lower representation in RCTs.
4. Among Medicare Patients With Chronic Asthma, 340B Not Eliminating Disparities
A report raised concerns about the 340B program's efficacy in reducing health disparities for Medicare patients with chronic asthma. The study compared patients treated at 340B health systems with those at non-340B hospitals meeting "disproportionate share" criteria. Disparities were observed, with non-White, dual-eligible, and low-SES patients less likely to receive certain treatments at 340B hospitals indicating that 340B discounts may not significantly curtail demographic disparities in asthma drug treatments and outcomes.
3. Building Better Equity-Based Benefit Designs
During a session at the value-based insurance design (VBID) summit, experts discussed the evolving landscape of health equity, acknowledging that innovations like VBID have been slow to gain traction. The panelists highlighted the pivotal role of George Floyd's murder in 2020 in bringing attention to health equity, prompting insurers to shift focus from internal efforts to addressing disparities. Efforts included forming social justice working groups and implementing equity-based benefit designs, such as reducing financial barriers for conditions that disproportionately affect communities of color.
2. Researchers Uncover Potential Racial Biases in T2D Risk Prediction Models
A study in PLOS Glob Public Health suggested the Prediabetes Risk Test (PRT) and type 2 diabetes (T2D) prediction models used in the US health care system may have racial bias, potentially perpetuating inequities. The investigation, which assessed the PRT, Framingham Offspring Risk Score, and ARIC Risk Model, found consistent miscalibration with regard to race. The models predicted higher T2D risks for white individuals than for black individuals, raising concerns about disparities in preventive interventions and treatment.
1. Bridging the Gap in Health Care Inequities: Considerations in Treatment Selection, Part 1
The most-read article featured part 1 of a 2-part podcast series. Ryan Haumschild, PharmD, and Bryan Buckley, DrPH, discussed how providers can address disparities in care related to race, cultural, and ethnic backgrounds.
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