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Found 805 results
  1. News Article
    The scope of the UK public inquiry into the handling of the Covid pandemic has widened to include a focus on children. When the draft terms were published in March, there was criticism that they failed to even mention the impact on children and young people. But after a public consultation, the final terms have been published and now incorporate the effect on the health, wellbeing and education of children. The final terms of reference were decided following a four-week public consultation on the draft terms. As well as expanding the terms to include the impact on the health, wellbeing and education of children and young people, the inquiry will also look at the wider mental health impact across the population. The focus on inequalities will also be strengthened, the inquiry said, so that the unequal impact on different sections of society will be considered at all stages. Alongside these issues, the UK-wide inquiry will also look at the following issues which were included originally: the UK's preparedness for the pandemic the use of lockdowns and other "non-pharmaceutical" interventions, such as social distancing and the use of face coverings the management of the pandemic in hospitals and care homes the procurement and provision of equipment like personal protective equipment and ventilators support for businesses and jobs, including the furlough scheme, as well as benefits and sick pay. Read full story Source: BBC News, 12 May 2022
  2. News Article
    A recent report based on research and case studies of good practice in combatting digital health inequalities demonstrates the importance in working with patients who are digitally excluded. The report, Putting patients first: championing good practice in combatting digital health inequalities, is the second report by the Patient Coalition for AI, Data and Digital Tech in Health. This report focuses on digital health inequalities and the impact that digital exclusion is having on health in the UK. It highlights different reasons for disparities in a person’s ability to access and use digital health technology and provides insights into the severity of the UK’s digital inequalities. The Coalition report concludes recommending that the Government and NHS should: Engage with those digitally excluded Ensure patients have a choice Ensure the language is appropriate for all audiences Learn from good practice. Read full story Source: The Patients Association, 9 May 2022
  3. News Article
    Women and babies in the UK are “dying needlessly” because of a lack of suitable medicines to use in pregnancy, according to a report that calls for a radical overhaul of maternal health. A “profound” shortage of research and the widespread exclusion of pregnant and breastfeeding women from clinical trials means hardly any new drugs are approved for common medical problems in pregnancy or soon after childbirth, the report finds. Meanwhile, scarce or contradictory information about the safety of existing medicines women may be taking for continuing conditions can make it impossible to reach a confident decision on whether or not to continue them in pregnancy, the experts add. “While pregnancy in the UK is generally considered safe, women and babies are still dying needlessly as a direct result of preventable pregnancy complications,” the authors say. Each year, 5,000 babies in the UK are either stillborn or die shortly after birth, while about 70 women die of complications in pregnancy. The Healthy Mum, Healthy Baby, Healthy Future report draws on evidence from patient groups, clinicians, researchers, lawyers, insurance specialists and the pharmaceutical industry, it proposes “urgent” changes to transform women’s access to modern medicine. The report highlights the “profound lack of research activity” and up-to-date information that leaves pregnant women and their physicians in the dark about whether to continue with certain medicines in pregnancy. Some epilepsy drugs, for example, can increase the risk of birth defects, but coming off them can put the woman at risk of severe seizures, which can also harm the baby. Lady Manningham-Buller said the situation “urgently needs to change”, with the report setting out eight recommendations to prevent needless deaths. Read full story Source: The Guardian, 12 May 2022
  4. News Article
    People in England are struggling to get dental treatment, as dentists close to new NHS patients, a watchdog says. Healthwatch England, the NHS body representing patients, said the problem was made worse by the rising cost of living and needed "urgent attention". It said some people were living in pain, unable to speak or eat properly, because they could not find treatment. And it warned the poorest were suffering most as they were least able to afford to pay for private dentistry. Healthwatch England said the issue was creating a two-tier system - dividing the rich and the poor - and called on the government to take action. "There is now a deepening crisis," said Louise Ansari, of Healthwatch England. "With millions of households bearing the brunt of the escalating living costs, private treatment is simply not an option - and even NHS charges can be a challenge. "This needs urgent attention." Read full story Source: BBC News, 9 May 2022
  5. News Article
    Trusts have been told to ‘get their act together’ on health inequalities, after HSJ research suggested only a small minority have so far published data on disparities in waiting times between different patient groups. Planning guidance issued by NHS England in September 2021 said trusts’ board performance reports should include a disaggregation of waiting lists by ethnicity and deprivation group. Through freedom of information and media requests, HSJ attempted to obtain such data from the 20 trusts with the largest waiting lists, but only three currently appear to have met the requirement in full. The remainder either said they were still undertaking the work, were thinking about how to publish it, or failed to respond. Roger Kline, an academic researcher and former director of NHSE’s workforce race equality standard, said trusts should have been collecting and publishing the data for years. He said: “We know there are issues around health and healthcare of some groups of people, most notably in poor working class communities and black and minority ethnic communities. It shouldn’t be seen as an optional extra, this should be part of good public health work and good equitable healthcare provision." “This data should be on the trust website. It should be an active part of the conversations with local communities. Well done to the trusts that are pushing this forward. The ones that are not need to get their act together.” Read full story (paywalled) Source: HSJ, 3 May 2022
  6. News Article
    The American Academy of Pediatrics is attempting to ban race-based medical guidance which the organisation attributes to long-standing inequities in healthcare. In a statement on Monday, the AAP said: “Race is a historically-derived social construct that has no place as a biologic proxy. Over the years, the medical field has inaccurately applied race correction or race adjustment factors in its work, resulting in differential approaches to disease management and disparate clinical outcomes.” “Although it will continue to be important to collect clinical data disaggregated by race and ethnicity to help characterize the differential lived experiences of our patients, unwinding the roots of race-based medicine, debunking the fallacy of race as a biologic proxy, and replacing this flawed science with legitimate measures of the impact of racism and social determinants on health outcomes is necessary and long overdue,” the academy added. A re-examination of AAP treatment recommendations that began before George Floyd’s 2020 murder by police in Minneapolis, and intensified after it and the resulting nationwide protests, has doctors concerned that Black youngsters have been under-treated and overlooked, said Joseph Wright, lead author of the new policy and chief health equity officer at the University of Maryland medical system, a network of hospitals. According to Wright, the academy has begun to scrutinise its “entire catalog,” including guidelines, educational materials, textbooks and newsletter articles. The academy went on to recommend a series of policies to medical societies, institutions and pediatricians. “All professional organizations and medical specialty societies should advocate for the elimination of race-based medicine in any form,” it said. It urged institutions to collaborate with learner-facing organizations such as the Accreditation Council on Continuing Medical Education to expose more people to health equity content with a “specific focus on the elimination of race-based medicine”. Read full story Source: The Guardian, 2 May 2022
  7. News Article
    Women with asthma are twice as likely to die from an asthma attack compared with men in the UK, new figures show as health experts called for urgent research into the condition’s sex-related differences. They are more likely to have the condition, more likely to need hospital treatment for it and more likely to die from an attack, Asthma + Lung UK said. Over the past five years women have accounted for more than two-thirds of asthma deaths in the UK. The charity said the current “one size fits all” approach to asthma treatment is “not working” because it does not take into account the impact that female sex hormones during puberty, periods, pregnancy and menopause can have on asthma symptoms and attacks. More must be done to tackle the “stark health inequality”, it added. Between 2014-15 and 2019-20 more than 5,100 women in the UK died from an asthma attack compared with fewer than 2,300 men. Meanwhile, emergency hospital admissions in England show that, among those aged 20 to 49, women were 2.5 times more likely to be admitted to hospital for asthma treatment compared with men. Asthma + Lung UK said many people were unaware that fluctuations in female sex hormones can cause asthma symptoms to flare up or even trigger life-threatening attacks. It is calling for more research to examine the sex-related differences in asthma. Read full story Source: The Guardian, 27 April 2022
  8. News Article
    The devastating impact of the Covid-19 pandemic on poor and low-income communities across America is laid bare in a new report that concludes that while the virus did not discriminate between rich and poor, society and government did. As the US draws close to the terrible landmark of 1 million deaths from coronavirus, the glaringly disproportionate human toll that has been exacted is exposed by the Poor People’s Pandemic Report. Based on a data analysis of more than 3,000 counties across the US, it finds that people in poorer counties have died overall at almost twice the rate of those in richer counties. Looking at the most deadly surges of the virus, the disparity in death rates grows even more pronounced. During the third pandemic wave in the US, over the winter of 2020 and 2021, death rates were four and a half times higher in the poorest counties than those with the highest median incomes. During the recent Omicron wave, that divergence in death rates stood at almost three times. Such a staggering gulf in outcomes cannot be explained by differences in vaccination rates, the authors find, with more than half of the population of the poorest counties having received two vaccine shots. A more relevant factor is likely to be that the poorest communities had twice the proportion of people who lack health insurance compared with the richer counties. “The findings of this report reveal neglect and sometimes intentional decisions to not focus on the poor,” said Bishop William Barber, co-chair of the Poor People’s Campaign which jointly prepared the research. “The neglect of poor and low-wealth people in this country during a pandemic is immoral, shocking and unjust.” Read full story Source: The Guardian, 4 April 2022
  9. News Article
    Gynaecology waiting lists in England have risen by 60% during the pandemic - more sharply than any other specialty. Across the UK, more than 570,000 women are waiting for help. The Royal College of Obstetricians and Gynaecologists (RCOG) said patients were "consistently deprioritised and overlooked". NHS England says hospitals are making progress on dealing with the Covid backlog and average waiting times for elective treatment are coming down. The RCOG is calling for much greater attention to women's views, and for care to be designed around their needs. Chetna Mistry says she is a "prisoner" to endometriosis, a painful condition in which tissue similar to the lining of the womb grows in other places, like the ovaries. She described it as "a whole-body disease which affects you physically and mentally". It has left her infertile, and, at 42, she needs a hysterectomy. Chetna said she was referred to a specialist in June 2020, but 21 months later still does not have a date for surgery. RCOG president Dr Edward Morris said he felt helpless not being able to speed up access to care for women and people on his waiting lists. "There is an element of gender bias in the system. I don't think believe that we are listening to voices of women as well as we should be. The priority they urgently need is not being given to them." The Royal College asked 830 women on waiting lists about the other impacts on their lives. Read full story Source: BBC News, 4 April 2022
  10. News Article
    It has long been clear that Black Americans have experienced high rates of coronavirus infection, hospitalisation and death throughout the pandemic. But those factors are now leading experts to sound the alarm about what will may come next: a prevalence of Long Covid in the Black community and a lack of access to treatment. Long Covid — with chronic symptoms like fatigue, cognitive problems and others that linger for months after an acute coronavirus infection has cleared up — has perplexed researchers, and many are working hard to find a treatment for people experiencing it. But health experts warn that crucial data is missing: Black Americans have not been sufficiently included in Long-Covid trials, treatment programmes and registries, according to the authors of a new report released on Tuesday. “We expect there are going to be greater barriers to access the resources and services available for Long Covid,” said one of the authors, Dr. Marcella Nunez-Smith, who is the director of Yale University’s health equity office and a former chair of President Biden’s health equity task force. “The pandemic isn’t over, it isn’t over for anyone,” Dr. Nunez-Smith said. “But the reality is, it’s certainly not over in Black America.” In the first three months of the pandemic, the average weekly case rate per 100,000 Black Americans was 36.2, compared with 12.5 for white Americans, the authors write. The Black hospitalisation rate was 12.6 per 100,000 people, compared with 4 per 100,000 for white people, and the death rate was also higher: 3.6 per 100,000 compared with 1.8 per 100,000. “The severity of Covid-19 among Black Americans was the predictable result of structural and societal realities, not differences in genetic predisposition.” "Many Black Americans who contracted the coronavirus experienced serious illness because of pre-existing conditions like obesity, hypertension and chronic kidney disease, which themselves were often the result of “differential access to high-quality care and health promoting resources,” the report says. Read full story (paywalled) Source: New York Times, 29 March 2022
  11. News Article
    The Royal College of Obstetricians and Gynaecologists (RCOG) has called for the immediate suspension of charging for NHS maternity care for migrant women because members say this government policy is harming the health of pregnant women and their babies. It is the first time the health professionals’ body has issued a position statement on this issue. The charity Maternity Action and the Royal College of Midwives have long expressed concern about the impact of NHS charging on this group of women. Charging forms a key plank of the Home Office’s hostile environment for migrants. The government says the charging policy is in place to deter health tourism but medics treating migrant pregnant women say there is little evidence that previously free NHS maternity care for all attracted health tourists. According to the 2019 MBRRACE-UK confidential inquiry into maternal deaths, three women were found to have died between 2015 and 2017 who may have been reluctant to access maternity care due to fears about charging and impact on their immigration status. Dr Brenda Kelly, an NHS consultant obstetrician working in Oxford, treats many pregnant migrant women. She is calling for the barriers to them accessing maternity care to be removed urgently. She described the case of one migrant woman who arrived in A&E shortly before delivering a stillborn baby. The woman had been fearful of coming forward for antenatal care although she was suffering from multiple, pregnancy-related health problems. “I hope I never have to hear cries like that woman’s cries ever again,” said Kelly. “The way to safeguard these women is to build up trust. If they are landed with a bill of several thousand pounds they will disengage. They are not health tourists, they are desperate. The commitment to maternal health equity means ending charges for maternity care. The time for action is now.” Read full story Source: The Guardian, 27 March 2022
  12. News Article
    During the peak of the omicron variant wave of the coronavirus this winter, Black adults in the United States were hospitalised at rates higher than at any moment in the pandemic, according to a report published last week by the Centers for Disease Control and Prevention. Black adults were four times as likely to be hospitalised compared with White adults during the height of the omicron variant surge, which started in mid-December and continued through January, the report said. In January, the CDC found, hospitalisation rates for Black patients reached the highest level for any racial or ethnic group since the dawn of the pandemic. As the highly transmissible omicron variant usurped the delta variant’s dominance, people who were unvaccinated were 12 times more likely to be hospitalised than those who were vaccinated and boosted against the coronavirus, according to the report. And fewer Black adults had been immunised compared with White adults, said the report, which analysed hospitalization rates in 99 counties in 14 states. Teresa Y. Smith saw evidence of the phenomenon outlined in the CDC’s report as she treated patients as an emergency physician at SUNY Downstate in Brooklyn. She has felt the crush of the pandemic’s unequal impact since the pre-vaccine waves but has contended with the consequences of health disparities for much longer. Her hospital sits in a heavily Black and Latino borough, where — as in so many communities of color across the country — social, political, economic and environmental factors erode health and shorten lives. In December, she watched as the number of cases and admissions resulting from the omicron variant “just exploded in a short, short amount of time,” saying then, “there is no subtlety to it.” And while the vaccinated patients she treated were less likely to be “lethally sick,” many still needed to be admitted to the hospital. Read full story Source: The Washington Post, 18 March 2022
  13. News Article
    Covid-19 is on the retreat across the American continents but it is too early for the region to let its guard down, warned the Pan American Health Organisation, the World Health Organization’s regional office for the Americas, on 9 March. Reported cases of Covid-19 fell by 26% in the past week and deaths by nearly 19%, as the omicron wave of infections tailed off. But ongoing transmission and future variants could expose the region’s public health priorities once more, said PAHO’s director, Carissa Etienne. A total of 2.6 million people have died from Covid-19 in the Americas, the highest number of any region of the world and almost half of the global total, despite being home to only 13% of its population. “This is a tragedy of enormous proportions, and its effects will be felt for years to come,” said Etienne on the second anniversary of the pandemic. Patchy vaccination coverage has left countries vulnerable to current and future variants of SARS-CoV-2. Around 248 million people in Latin America and the Caribbean are yet to receive a single dose of a covid vaccine, with vaccination rates particularly low in hard-to-reach rural areas. In the first two months of 2022 the Americas accounted for 63% of the world’s new cases. Despite a general fall in incidence across the region, new cases rose by 2.2% in the Caribbean, while Bolivia and Puerto Rico reported an increase in deaths in the past week. Michael Touchton, head of the University of Miami’s Covid-19 policy observatory for Latin America, said, “Latin America is perhaps the most vulnerable region in the world to the emergence of a new variant. Vaccine delays have a greater impact in Latin America due to concentrated urban populations, chronic disease burden, and low capacity health systems. Taken together, Latin America is likelier to fare worse than other similarly low and middle income regions.” Read full story Source: BMJ, 14 March 2022
  14. News Article
    The General Medical Council (GMC) has achieved marginal improvements against its targets to reduce racial inequalities, it said in an annual update on the programme. However, BAME doctor representatives as well as the GMC itself said the progress was not sufficient against the targets which the regulator had set itself last year. These included stopping disproportionate complaints from employers about ethnic minority doctors by 2026, and getting rid of disadvantage and discrimination in medical education and training by 2031. According to the update, the gap between employer referral rates for ethnic minority doctors and international medical graduates, compared to white doctors, has marginally reduced. The report also acknowledged the judgment by an employment tribunal in June last year, which found that the GMC had discriminated against a doctor based on his race. Reading Employment Tribunal upheld a complaint that Dr Omer Karim, who previously worked as a consultant urologist in Slough, had been discriminated against during an investigation by the GMC, after the body dismissed charges against a white doctor accused of the same conduct. The GMC has appealed the verdict but is still waiting for the appeal to be heard. Read full story Source: Pulse, 10 March 2022
  15. News Article
    Vulnerable people released from immigration detention in the UK are too often left without crucial continuity of care, leading to quickly deteriorating health, concludes a report. The report comes from Medical Justice, a charity that sends independent volunteer clinicians into immigration removal centres across the UK to offer medical advice and assessments to immigration detainees. The charity said that between 1 October 2020 and 30 September 2021 a total of 21 362 people were detained in UK immigration centres and 17 283 were released into the community, having been granted bail or leave to enter the UK or remain. Of these, 2239 were considered to be “adults at risk.” One woman whose delay in treatment “could potentially have life or limb threatening consequences”, struggled to re-arrange an orthopaedic oncology appointment that she missed because she had been detained. One released Medical Justice client described how he ended up a number of times in Accident & Emergency, having been unable to secure a recommended cardiology appointment. The report found that release from detention is often unplanned, chaotic and medically unsafe. Medical Justice sees repeated cases of vulnerable people released into the community without adequate care plans, with little or no information and support about entitlement and how to access a GP, and rarely with referrals to community support services such as local mental health teams. This has included people who had very recently attempted suicide in detention. Read full story Source: BMJ, 4 March 2022
  16. News Article
    The NHS has been accused of “shocking and systemic” racism during the pandemic as black healthcare workers say they were given poor PPE and pushed into the Covid frontline first. Hundreds of black and brown healthcare staff across the UK have spoken to academics at Sheffield Hallam University about their experiences of racism during the pandemic. The accounts raised issues of racism within the health service which led to black and brown nurses and midwives being put at greater risk than their white colleagues, due to poorer PPE, training, workload and shift patterns. Rosalie Sanni-Ajose, a senior theatre practitioner, who worked across multiple London NHS hospitals through an agency called Yourworld told The Independent: “During the pandemic, we found that most of us (black agency nurses) have been placed in ITU to look after Covid patients are on a Continuous positive airway pressure (CPAP) machine or the ventilator." “Then when I work in A&E, they divided areas into sections - green area, red area, and the normal areas. So some of the ethnic minority staff were then put in the red areas all the time. Further some of us, we have comorbidities like asthma, or diabetes, or have an exemption that has been clearly stated they not allowed to work there.” Through its research, which involved 350 black and brown nurses, midwives and healthcare staff across the UK, Sheffield Hallam University found 77% of respondents said they’d been treated unfairly when they challenged racism. Just over 50% of the respondents said they’d experienced unfair treatment in the pandemic in relation to Covid deployment, PPE or risk assessment. One third have left their job as a result of racism, while more than half have experienced poor mental health due to the racism they experienced. The academic team, lead by Professor Anandi Ramamurthy said the healthcare professionals’ reports reveal “a story of systematic neglect and harassment which predates the pandemic.” Read full story Source: The Independent, 5 March 2022
  17. News Article
    Stark disparities in cancer rates between different ethnic groups have been laid bare in new research showing black people are twice as likely to get prostate cancer while white people have double the chance of getting skin and lung cancers. The analysis of NHS Digital cancer registration data by Cancer Research UK provides the most complete recording ever of cancer rates by ethnicity in England, offering crucial data on how some rates vary. The results are published in the British Journal of Cancer. White people in England are more than twice as likely to get some types of cancer, including melanoma skin cancer, oesophageal, bladder and lung cancers compared with people from black, Asian or mixed ethnic backgrounds, according to the research. Black people are almost three times more likely to get myeloma and almost twice as likely to get prostate cancer compared with white people. The study also found that black people are more likely to get stomach and liver cancers, and Asian people are more likely to get liver cancers. Genetics are thought to play a part in some of the findings, Cancer Research UK said. For example, white people are more likely to get skin cancer because they tend to burn more easily in the sun. Preventable risk factors also appear to be involved, the charity added, as white people are more likely than most minority ethnic groups to smoke or be overweight or obese. These are the two largest risk factors in developing cancer and help explain why white people are more likely to get some types of cancer than other ethnic groups. Read full story Source: The Guardian, 2 March 2022
  18. News Article
    A new pregnancy screening tool cuts the risk of baby loss among women from black, Asian and ethnic minority backgrounds to the same level as white women, research suggests. The app calculates a woman's individual risk of pregnancy problems. In a study of 20,000 pregnant women, baby death rates in ethnic groups were three times lower than normal when the tool was used. Experts say the new approach can help reduce health inequalities. The screening tool is already in use at St George's Hospital in London and is being tried out at three other maternity units in England, with hopes it could be rolled out to 20 centres within two years. Researchers from Tommy's National Centre for Maternity Improvement, led by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives, developed the new tool. Professor Basky Thilaganathan, who led the research team at St George's Hospital, said the new approach could "almost eliminate a large source of the healthcare inequality facing black, Asian and minority ethnic pregnant women". "We can personalise care for you and reduce the chances of having a small baby, pre-eclampsia and losing your baby," he said. The current system of a tick-box checklist to assess pregnancy risk has been around for 70 years, and is limited. The new digital tool, which uses an algorithm to calculate a woman's personal risk, can detect high-risk women more accurately and prevent complications in pregnancy, the researchers say. Both pregnant women and maternity staff can upload information on their pregnancy and how they are feeling to the app during antenatal appointments and at other times. Dr Edward Morris, president of the Royal College of Obstetricians and Gynaecologists, said it was "unacceptable" that black, Asian and minority ethnic women faced huge inequalities on maternity outcomes. "The digital tool provides a practical way to support women with personalised care during pregnancy and make informed decisions about birth. Read full story Read Tommy's press release Source: BBC News, 28 February 2022
  19. News Article
    The NHS has been accused by a major charity of failing to address the emerging gap in Covid booster vaccine coverage for racialised communities. Blood Cancer UK has told The Independent it has “serious concerns” over what it claims is a “shocking” lack of urgency from the NHS in addressing the gap in booster vaccine doses for immunocompromised people from black and minority ethnic communities. The charity has said NHS England has failed to set out any “concrete” plans since it revealed 84% of immunocompromised people from a white British background had three vaccine doses by mid-December, compared to just 43% of immunocompromised people from a Pakistani background. The news comes after the government announced people over 75 and immunocompromised children would be eligible to receive a fourth Covid vaccine by Spring. According to an analysis published by Open Safely, a team of data scientists at Oxford University, of those who are part of the shielding population, as of the 22 February just 72% of Black people have had their booster does, and 73% of south Asian people. This compares to 89% of white people. NHS England has highlighted a number of actions it is taking to address the situation such as using pop-up sites within communities and providing free transport. Speaking with The Independent chief executive of Blood Cancer UK Gemma Peters, said: “We have serious concerns about how the poor roll-out of third doses for the immunocompromised has left people from some communities much less well-protected than people from a white British background. But while it is deeply troubling that a racial disparity in access to third vaccine doses has been allowed to develop, just as shocking has been NHS England’s apparent lack of urgency in addressing it." Read full story Source: The Independent, 25 February 2022
  20. News Article
    Pregnancy-related deaths among US mothers climbed higher in the pandemic’s first year, continuing a decades-long trend that disproportionately affects Black people, according to a new government report. Overall in 2020, there were almost 24 deaths per 100,000 births, or 861 deaths total, numbers that reflect mothers dying during pregnancy, childbirth or the year after. The rate was 20 per 100,000 in 2019. Among Black people, there were 55 maternal deaths per 100,000 births, almost triple the rate for white people. The report from the National Center for Health Statistics does not include reasons for the trend and researchers said they have not fully examined how Covid-19, which increases risks for severe illness in pregnancy, might have contributed. The coronavirus could have had an indirect effect. Many people put off medical care early in the pandemic for fear of catching the virus, and virus surges strained the healthcare system, which could have had an impact on pregnancy-related deaths, said Eugene Declercq, a professor and maternal death researcher at Boston University School of Public Health. He called the high rates “terrible news” and noted that the US has continually fared worse in maternal mortality than many other developed countries. Reasons for those disparities are not included in the data, but experts have blamed many factors including differences in rates of underlying health conditions, poor access to quality healthcare and structural racism. Read full story Source: The Guardian, 23 February 2022
  21. News Article
    A taskforce has been set up to tackle disparities in maternity care experienced by women belonging to ethnic minorities and those living in deprived areas. Black women are 40% more likely to miscarry than white, studies suggest. Maternal death rates are also higher among black and Asian women. Royal College of Obstetricians and Gynaecologists head Dr Edward Morris told BBC News implicit racial bias was affecting some women's care. Patient Safety and Primary Care Minister Maria Caulfield said: "For too long disparities have persisted which mean women living in deprived areas or from ethnic minority backgrounds are less likely to get the care they need and, worse, lose their child. "We must do better to understand and address the causes of this. "The Maternity Disparities Taskforce will help level-up maternity care across the country, bringing together a wide range of experts to deliver real and ambitious change so we can improve care for all women - and I will be monitoring progress closely." Chief midwifery officer Prof Jacqueline Dunkley-Bent, who will co-chair the taskforce, said: "The NHS's ambition is to be the safest place in the world to be pregnant, give birth and transition into parenthood - all women who use our maternity services should receive the best care possible." The taskforce will meet every two months and focus on: improving personalised care and support plans addressing how wider societal issues affect maternal health improving education and awareness of health when trying to conceive, such as taking supplements and maintaining a healthy weight increasing access to maternity care for all women and developing targeted support for those from the most vulnerable groups empowering women to make evidence-based decisions about their care. Read full story Source: BBC News, 23 February 2022 Source: BBC News,
  22. News Article
    Medical records contain a plethora of information, from a patient’s diagnoses and treatments to marital status to drinking and exercise habits. They also note whether a patient has followed medical advice. A health provider may add a line stating that the patient is “noncompliant” or “non-adherent,” signalling that the patient has been uncooperative and may exhibit problematic behaviours. Two large new studies in the US found that such terms, while not commonly used, are much more likely to appear in the medical records of Black patients than in those of other races. The first study, published in Health Affairs, found that Black patients were two and a half times as likely as white patients to have at least one negative descriptive term used in their electronic health record. About 8% of all patients had one or more derogatory terms in their charts, the study found. The most common negative descriptive terms used in the records were “refused,” “not adherent,” “not compliant” and “agitated.” The second study, published in JAMA Network Open, analysed the electronic health records of nearly 30,000 patients at a large urban academic medical centre between January and December 2018. The study looked for what researchers called “stigmatising language,” comparing the negative terms used to describe patients of different racial and ethnic backgrounds as well as those with three chronic diseases: diabetes, substance use disorders and chronic pain. Overall, 2.5% of the notes contained terms like “nonadherence,” “noncompliance,” “failed” or “failure,” “refuses” or “refused,” and, on occasion, “combative” or “argumentative.” But while 2.6% of medical notes on white patients contained such terms, they were present in 3.15% of notes about Black patients. Looking at some 8,700 notes about patients with diabetes, 6,100 notes about patients with substance use disorder and 5,100 notes about those with chronic pain, the researchers found that patients with diabetes — most of whom had type 2 diabetes, which is often associated with excess weight and called a “lifestyle” disease — were the most likely to be described in negative ways. Nearly 7% of patients with diabetes were said to be noncompliant with a treatment regimen, or to have “uncontrolled” disease, or to have “failed.” The labels have consequences, warns Dr. Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center. “Patients whose physicians tend to judge, blame or vilify them are much less likely to have trust in their doctors, and in the medical system overall,” Dr. Schillinger said. “Having health care providers who are trustworthy — who earn their patients’ trust by not judging them unfairly — is critical to ensuring optimal health and eliminating health disparities.” Read full story (paywalled) Source: The New York Times, 20 February 2022
  23. News Article
    Callers to NHS 111 services are twice as likely to be judged as needing an ambulance in some regions as others – and up to eight times more likely to abandon their calls. An HSJ investigation has revealed striking differences in performance between 111 providers. The new integrated urgent care data set, published by NHS England, shows the differences in performance across the country. HSJ analysed data from April to December last year – the first year this data set has been produced. For example, 15.7% of answered calls to North East Ambulance Service Foundation Trust resulted in an “ambulance disposition” while just 7.7% of calls to London Ambulance Service Trust did so. A total of 14.2% of callers to the privately owned Practice Plus Group were judged to require an ambulance. 41.9% of calls were abandoned before being answered by NEAS and 30.6% of those made to the West Midlands Ambulance Service University FT ended the same way. In contrast just 5.2%of callers from Lincolnshire to services provided by Derbyshire Health United abandoned their calls. The “standard” for abandoned calls is just 3%, but the average performance across England was 24.1%. In a statement, the Practice Plus Group said its staff were trained to a high standard on NHS Pathways and it was confident its staff were making appropriate and safe decisions. Over 70 per cent of decisions to instigate a category 3 or 4 ambulance callout were validated in January. As a result ambulances were dispatched in just 20 per cent of those cases, with other patients being directed to alternative pathways. “We are always looking to enhance the service which is why we are running developmental training for our call handlers in more effective probing to reduce the category 2 ambulance disposition numbers and have introduced GoodSam video technology as part of an NHSE pilot which will support clinicians with eyes on with a patient,” the company added. Read full story (paywalled) Source: HSJ, 18 February 2022
  24. News Article
    Tonjanic Hill was overjoyed in 2017 when she learned she was 14 weeks pregnant. Despite a history of uterine fibroids, she never lost faith that she would someday have a child. But, just five weeks after confirming her pregnancy she seemed unable to stop urinating. She didn’t realize her amniotic fluid was leaking. Then came the excruciating pain. “I ended up going to the emergency room,” said Hill, now 35. “That’s where I had the most traumatic, horrible experience ever.” An ultrasound showed she had lost 90% of her amniotic fluid. Yet, over the angry protestations of her nurse, Hill said, the attending doctor insisted Hill be discharged and see her own OB-GYN the next day. The doctor brushed off her concerns, she said. The next morning, her OB-GYN’s office rushed her back to the hospital. But she lost her baby. Black women are less likely than women from other racial groups to carry a pregnancy to term — and in Harris County, where Houston is located, when they do, their infants are about twice as likely to die before their 1st birthday as those from other racial groups. Black fetal and infant deaths are part of a continuum of systemic failures that contribute to disproportionately high Black maternal mortality rates. “This is a public health crisis as it relates to Black moms and babies that is completely preventable,” said Barbie Robinson, who took over as executive director of Harris County Public Health in March 2021. “When you look at the breakdown demographically — who’s disproportionately impacted by the lack of access — we have a situation where we can expect these horrible outcomes.” Read full story Source: KFF Health News, 24 August 2023
  25. News Article
    An NHS body is encouraging women with breast cancer from minority backgrounds to take part in more clinical trials, after research found they are under-represented in studies that can offer life-saving treatment. The pilot project, supported by the NHS Race and Health Observatory, is intended to improve representation in breast cancer clinical trials partly through culturally sensitive communications to people from racially diverse backgrounds. Research from the UK Health Security Agency suggests young black women are more likely to have aggressive breast cancer tumours, experience poorer care and have higher mortality rates, but are significantly under-represented in clinical research. Their lack of inclusion in trials could be partly down to distrust of the research process and a lack of knowledge, according to research by the UK’s National Institute for Health Research. The project, which works in conjunction with Macmillan Cancer Support and the pharmaceutical company Roche, will run for a year and look at developing new ways for people with breast cancer to access clinical trials. It will develop action plans to improve representation and provide enhanced support for patients. Read full story Source: The Guardian, 31 August 2023
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