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TITLE: Women and Minorities Bear the Brunt of Medical Misdiagnosis
https://kffhealthnews.org/news/article/medical-misdiagnosis-women-minorities-health-care-bias/
EXCERPTS: In a study published Jan. 8 in JAMA Internal Medicine, researchers found that nearly 1 in 4 hospital patients who died or were transferred to intensive care had experienced a diagnostic error. Nearly 18% of misdiagnosed patients were harmed or died.
In all, an estimated 795,000 patients a year die or are permanently disabled because of misdiagnosis, according to a study published in July in the BMJ Quality & Safety periodical.
Some patients are at higher risk than others.
Women and racial and ethnic minorities are 20% to 30% more likely than white men to experience a misdiagnosis, said David Newman-Toker, a professor of neurology at Johns Hopkins School of Medicine and the lead author of the BMJ study. “That’s significant and inexcusable,” he said.
Maternal mortality for Black mothers has increased dramatically in recent years. The United States has the highest maternal mortality rate among developed countries. According to the Centers for Disease Control and Prevention, non-Hispanic Black mothers are 2.6 times as likely to die as non-Hispanic white moms. More than half of these deaths take place within a year after delivery.
Research shows that Black women with childbirth-related heart failure are typically diagnosed later than white women, said Jennifer Lewey, co-director of the pregnancy and heart disease program at Penn Medicine. That can allow patients to further deteriorate, making Black women less likely to fully recover and more likely to suffer from weakened hearts for the rest of their lives.
Black people with depression are more likely than others to be misdiagnosed with schizophrenia.
Minorities are less likely than whites to be diagnosed early with dementia, depriving them of the opportunities to receive treatments that work best in the early stages of the disease.
Misdiagnosis isn’t new. Doctors have used autopsy studies to estimate the percentage of patients who died with undiagnosed diseases for more than a century. Although those studies show some improvement over time, life-threatening mistakes remain all too common, despite an array of sophisticated diagnostic tools, said Hardeep Singh, a professor at Baylor College of Medicine who studies ways to improve diagnosis.
“The vast majority of diagnoses can be made by getting to know the patient’s story really well, asking follow-up questions, examining the patient, and ordering basic tests,” said Singh, who is also a researcher at Houston’s Michael E. DeBakey VA Medical Center. When talking to people who’ve been misdiagnosed, “one of the things we hear over and over is, ‘The doctor didn’t listen to me.’”
Racial disparities in misdiagnosis are sometimes explained by noting that minority patients are less likely to be insured than white patients and often lack access to high-quality hospitals. But the picture is more complicated, said Monika Goyal, an emergency physician at Children’s National Hospital in Washington, D.C., who has documented racial bias in children’s health care.
In a 2020 study, Goyal and her colleagues found that Black kids with appendicitis were less likely than their white peers to be correctly diagnosed, even when both groups of patients visited the same hospital.
Although few doctors deliberately discriminate against women or minorities, Goyal said, many are biased without realizing it.
“Racial bias is baked into our culture,” Goyal said. “It’s important for all of us to start recognizing that.”
TITLE: Premium hikes outpacing employee wages, especially for Blacks, Hispanics
https://www.healthcarefinancenews.com/news/premium-hikes-outpacing-employee-wages-especially-blacks-hispanics
EXCERPT: Employee wages have been unable to keep pace with the rising costs of premiums in employee-sponsored coverage, and the disparity is having an outsized effect on Black and Hispanic employees in particular, a new study in JAMA Network Open has found.
Over more than three decades, from 1988 to 2019, health insurance premiums increased from 7.9% of compensation (wages plus premiums) to 17.7% of compensation for families with employer-sponsored insurance (ESI). Black and Hispanic families with ESI lost a higher percentage of their wages than white families to increasing healthcare premiums.
By 2019, premiums as a percentage of compensation were 19.2% for Black families and 19.8% for Hispanic families, while they were only 13.8% for white families.
The study attributed this in part to structural racism across the U.S. economy, including in education and hiring, meaning a larger proportion of Black and Hispanic workers have been employed in lower-paying jobs, even among workers with employer insurance. By receiving lower earnings historically, Black and Hispanic households shoulder a greater proportion of the increase in healthcare premiums as a percentage of their compensation.
"Thus, ESI may partially maintain interconnected historical inequities surrounding structural racism, earnings, and healthcare use," authors wrote.
Employee wages have been unable to keep pace with the rising costs of premiums in employee-sponsored coverage, and the disparity is having an outsized effect on Black and Hispanic employees in particular, a new study in JAMA Network Open has found.
Over more than three decades, from 1988 to 2019, health insurance premiums increased from 7.9% of compensation (wages plus premiums) to 17.7% of compensation for families with employer-sponsored insurance (ESI). Black and Hispanic families with ESI lost a higher percentage of their wages than white families to increasing healthcare premiums.
By 2019, premiums as a percentage of compensation were 19.2% for Black families and 19.8% for Hispanic families, while they were only 13.8% for white families.
The study attributed this in part to structural racism across the U.S. economy, including in education and hiring, meaning a larger proportion of Black and Hispanic workers have been employed in lower-paying jobs, even among workers with employer insurance. By receiving lower earnings historically, Black and Hispanic households shoulder a greater proportion of the increase in healthcare premiums as a percentage of their compensation.
"Thus, ESI may partially maintain interconnected historical inequities surrounding structural racism, earnings, and healthcare use," authors wrote.
TITLE: For Patients With Chronic Inflammation, Poverty Increases Cardiovascular Risk
https://www.pharmacytimes.com/view/for-patients-with-chronic-inflammation-poverty-increases-cardiovascular-risk
EXCERPT: For patients with chronic inflammation, the effects of poverty could reduce health and life expectancy even further, demonstrating that this population has significantly worse health outcomes independent from their health effects, according to results of a study published in Frontiers in Medicine.1,2
“We found that participants with either inflammation or poverty alone each had about a 50% increased risk in all-cause mortality. In contrast, individuals with both inflammation and poverty had a 127% increased heart disease mortality risk and a 196% increased cancer mortality risk,” Frank A. Orlando, MD, FAAFP, an associate professor at the University of Florida, said in the press release. “Since the observed 127% and 196% increases are much greater than 100%, we conclude that the combined effect of inflammation and poverty on mortality is synergistic.”1
According to a press release, it has been shown that poverty negatively impacts physical and mental health, showing those in poverty have greater risks of mental illness, heart disease, hypertension, stroke, and higher mortality and lower life expectancy. Investigators of the current study were the first to show the effects on poverty with chronic inflammation. Chronic inflammation can be caused by exposure to environmental toxins, certain diets, autoimmune disorders, and other chronic diseases, according to the press release.1