The Health Divide: Top hospital faces federal probe on treatment of Black moms; plus racism’s link to childhood obesity

Date:

by CHJ Fellow Amber Dance

LA hospital in hot water over Black maternity care

One of the nation’s top hospitals is undergoing a federal civil rights investigation stemming from the 2016 postpartum death of a Black woman in its care, report Deena Zaru and Brittany Gaddy at ABC News.

Kira Dixon Johnson, who delivered a son by Caesarian section at Cedars-Sinai Medical Center in Los Angeles, began bleeding postpartum, but was not taken for treatment until 10 hours later, said her husband, Charles Johnson. She died from internal bleeding.

The U.S. Department of Health and Human Services had little to tell ABC about the investigation for now, other than the fact that the Biden-Harris administration considers maternal health a priority. 

“The U.S. is in the midst of a mounting maternal mortality crisis,” writes Annalisa Merelli at STAT. Data are spotty, but the risk of death for U.S. women is, on average, 10 times that in comparable nations — and that figure rises to 20 times higher for Black and Native moms.

Moreover, the situation is getting worse: maternal mortality more than doubled between 1999 and 2019, according to a recent JAMA paper

A new United Nation analysis blames racism and sexism for the high rates of pregnancy complications and death experienced by Black women across the Americas, report Emily Baumgaertner and Farnaz Fassihi at The New York Times

For example, Black women were more likely than white women to report being denied medication or being physically or verbally abused by health care providers.

Faulty medical school instruction about Black women contribute to the problem, according to the U.N. report. For example, incorrect information that Black women’s blood coagulates faster can lead to delayed treatment for bleeding, such as Kira Dixon Johnson experienced.

The state of Black maternal health in the Americas is “a human rights crisis that is largely ignored or overlooked by decision makers,” said Dr. Natalia Kanem, executive director of the U.N. Population Fund.

The solution is to address the root causes of bias and health care access, Dr. Abdulla al-Khan told Steven Ross Johnson at U.S. News & World Report

“The tolerance for disparities should be zero in the health care profession,” said al-Khan, co-director of the Fetal Care Center at Hackensack University Medical Center in New Jersey.

Alzheimer’s drug may be out of reach for Black patients

The FDA has approved a new drug, lecanemab, to slow Alzheimer’s disease, but it may exacerbate a racial divide in care, reports Arthur Allen at KFF Health News.

Lecanemab, which goes by the brand name Leqembi, is for people in the early stages of Alzheimer’s and requires biweekly infusions as well as careful monitoring of patients to check for potential side effects of bleeding or swelling in the brain. Those requirements, plus the $26,500 annual price tag, would put Leqembi out of reach for lower-income patients, physicians told Allen.

“The most likely consequence of this medication is to take resources away from addressing basic supports for older adults with cognitive impairment,” said epidemiologist Maria Glymour of the Boston University School of Public Health. 

Another problem is that only 20 people out of 859 who received the drug in the clinical trial were Black — despite the fact that Alzheimer’s is up to twice as common in Black as white individuals. 

That lack of trial diversity means it’s not certain if lecanemab is even safe or effective in Black people, one of Allen’s sources suggested.

Racism linked to childhood obesity

Children who report experiencing racial discrimination are more likely to be obese, according to a new study in JAMA Network Open.

The work adds to research that links stress from racism to weight in adults.

Children of color are aware of unfair treatment, “and this has huge, huge implications for their life course trajectory when it comes to their health,” study co-author Adolfo Cuevas of the NYU School of Global Public Health told Karen Weintraub at USA Today.

The study, which included more than 6,000 children ages 9 through 11, found the highest rates of obesity in Black Americans and children whose parents were in the lowest income category. 

It’s not clear if racism, parental education, or family income is most influential for obesity, Cuevas said. 

But the link between racial discrimination and obesity, as measured by waist circumference and body mass index (BMI), held true even after the researchers accounted for other factors such as age, sex, and parental education.

Obesity was also higher in Hispanic children and Native American and Alaska Native children.

Since the study only observed children, it can’t directly confirm that experiences of racism cause obesity.

While the effects of discrimination on weight were small over the two-year period covered in the study, they could add up, the authors wrote: “Even repeated small experiences of discrimination could impact risk of obesity, especially for those who are already vulnerable.”

Black men most likely to die of melanoma

Racial disparities in cancer are well documented, and a new study adds further evidence of the persistent trend.

Men are more likely to die of melanoma than women, and Black men are the most vulnerable overall, according to the study in the Journal of the American Academy of Dermatology.

The study emphasizes that even though melanoma is rare overall in Black people, it’s important to look out for it and train doctors to identify it on patients of color, reports Andrea Atkins at The Washington Post.

Men are more than twice as likely as women to die of melanoma — probably because women seek medical care earlier in the disease, giving them a better chance at beating it, said study co-author Ashley Wysong of the University of Nebraska Medical Center. 

But even after accounting for the difference in diagnosis time, men were still more likely to die, she added, suggesting there are other contributors, perhaps hormones. About one in 27 men will be affected by melanoma at some point in his lifetime, compared to one in 40 women, according to the American Academy of Dermatology

Among men, whites were most likely to survive the cancer, at a rate of 75%, while only 52% of Black men survived, reports Sara Moniuszko at CBS News. Survival rates for Hispanic, Asian and Native American men fell in between.

Part of the disparity may stem from where melanoma typically first appears: on the torso, head and neck in most white men, but on the hips or legs of many Black men. The spots on Black men may be less noticeable to them or their friends and family members, leading to later diagnoses.

The study of more than 200,000 men, based on 14 years of data from the National Cancer Database, is the largest to date to focus on race in men with melanoma, writes Moniuskzo.

Rural and Black reps missing from opioid settlement councils

The nation’s rural counties have the highest rates of opioid overdose deaths, as well as fewer doctors and clinics to treat addiction. But these areas are not getting ample representation on state committees that will distribute more than $50 billion in compensation from companies that made or sold opioid painkillers, reports Aneri Pattani at KFF Health News.

The decision-making councils have wide latitude in how the restitution money is used: it could fund relief programs such as addiction treatment or recovery houses, and could also be be used for law enforcement expenses such as narcotics detectives and prisons, Pattani reports.

And while the rate of overdose deaths is rising fast in Black Americans, who already have difficulty accessing the best treatments, they’re also being left off the councils, writes Pattani.

“There’s this perception that this money is not for people who look like me,” said Philip Rutherford, who is Black and the chief operating officer of the nonprofit Faces & Voices of Recovery.

There are also few council seats designated for people who have dealt with a substance use disorder personally or supported a family member through the problem.

“Having diverse representation in the room is going to make sure there is a balance on how the funds are spent,” said Kristen Pendergrass, vice president of state policy at the nonprofit Shatterproof, which worked with KFF Health News and Johns Hopkins University to gather data on the council members.

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