'Asian American' category obscures health disparities among different racial and ethnic groups

"If people are not seen in the data, you can have lofty health equity goals but have blind spots that harm those populations." — Ninez Ponce

November 21, 2023 Check out STAT+

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By Elizabeth Cooney Reporter, Morning Rounds Writer

Good morning. Here's a striking fact from Usha Lee McFarling's story on the implications of lumping Asian Americans into one medical category: Cancer is the leading cause of death for Asians overall, but deaths due to heart disease for Indian Asians are actually twice as common as deaths due to cancer.

health inequities Broad 'Asian American' category can make health disparities disappear  Thumỹ Phan for STAT When you combine people with ancestries from 50 different countries in one racial category — in this case "Asian" —  it can be bad for their health. Overall life expectancy for Asian Americans as a group is 83.5 years, compared with 76.1 for white Americans. But break out data by subcategories and you'll see a range of poor health outcomes, including higher rates of liver cancer among Laotian Americans, cervical cancer among Hmong women, and diabetes for Filipino and Asian Indian Americans. Research is just beginning to account for such variations.   One analysis of 76 studies focused on Asian health found most centered on Americans of Chinese, Japanese, or Filipino descent; people who were of Indonesian, Burmese or Malaysian descent were included in just one or two. "If people are not seen in the data, you can have lofty health equity goals but have blind spots that harm those populations." UCLA's Ninez Ponce told Usha. Read more. drug safety Eye drops recall demonstrates FDA's limitations Eye drops have been in the news lately, and not in a good way. After FDA inspectors found unsanitary conditions at a facility in India that makes over-the-counter eye drop products sold by multiple U.S. retailers and distributors under their own brand names, the agency requested a recall. CVS Health, Rite Aid, and Target immediately took the products off their shelves and websites, but it took nearly three weeks for Kilitch Healthcare India, maker of the eye drops, to recall them. Kilitch did not respond to a request for comment. Meanwhile, the FDA warned the public not to buy products branded as Leader, Rugby, and Velocity. The FDA also blocked imports of the eye drops and contacted the manufacturer and the distributor to recommend recalls. "Recommend" is the key word here for the action on eye drops, which must be sterile as drugs applied to eyes bypass some of the body's natural defenses. Rep. Frank Pallone (D-N.J.) wants the FDA to have mandatory recall authority and require labels to list the manufacturer. STAT's John Wilkerson explains.

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closer look Medtech mentor Paul Grand's goal: Making sure founders don't make avoidable mistakes Eric Thayer for STAT  Back in 2013, when everything was "so doomy and gloomy," Paul Grand (above) came up with MedTech Idol, a startup competition that became an instant hit on the device-conference circuit. One cease-and-desist letter from American Idol and 10 years later, as STAT's Lizzy Lawrence puts it, MedTech Idol has become MedTech Innovator. Now 612 companies have gone through it, earning $7 billion in follow-up investments. At its heart is help: "A lot of companies were making mistakes that were avoidable," Grand said. "You chose the wrong CEO, you worked with the wrong vendor, you designed your clinical trials wrong, your device was too expensive. You name it." Grand believes medtech fundraising shouldn't be so hard. "The next AI startup, with no revenue and really, no idea how they're ever gonna make money, is already a $3 billion company," Grand said. "Yet a medtech company that's going to allow people to avoid an early death from something that's preventable is valued at 400 million." Read more. reproductive health Infertility itself, not treatments, may explain slightly higher risk of autism spectrum disorders Some studies exploring the risk of autism spectrum disorder have found an association with fertility treatment, but a paper published yesterday in JAMA Network Open suggests infertility itself — or complications during pregnancy and delivery — could play a more important role. To reach their conclusion, researchers studied more than 1.6 million births in Ontario, Canada, finding a slightly higher risk of autism in children born to people who have infertility compared to those without. But because four different fertility treatments did not appear to introduce any measurable risk of autism compared with having low fertility alone, researchers say underlying infertility might be the link to childhood autism, and not the fertility treatments themselves. "The findings of this study should not change the decision of any parent trying to conceive," Andrew Whitehouse of the University of Western Australia said in a statement shared by the Science Media Centre. first opinion An entrepreneur's fix for the pharmacists shortage: prescriptions that last longer Pharmacists have reached their limits. Overwhelmed by their working conditions, they've organized walkouts, including at Walgreens and CVS,  saying they worry understaffing makes it unsafe for patients who depend on their attention to detail. Pharmacies upped their game during the pandemic, offering vaccination and something like pharmacists' vision of providing more expansive clinical services, but financial pressures on the bottom line make new hiring in support of that goal unfeasible. Stephen Buck, a pharmaceutical supply specialist who co-founded GoodRx, has another idea for doing more with the same resources: "Increase the use of 12-month prescriptions, by which I mean not prescriptions that are valid for a year, but those that you have to fill only once to receive a year's supply," not every 30 or 60 days, he writes in a STAT First Opinion. "Quite often, the majority of a cost in filling an inexpensive generic medication is the pharmacy labor and overhead instead of the actual cost of the pills." Read more.

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What we're reading Opinion: The big #MeToo moment for doctors is finally here, New York Times More free Covid-19 tests from the government are available for home delivery through the mail, Associated Press Why these PhD scientists swapped research for secondary-school teaching, Nature California countertop workers died of a preventable disease. The threat was known years earlier, Los Angeles Times U.K., pharma industry strike deal for how the NHS pays for medicines, STAT

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Thanks for reading! More tomorrow,

elizabeth.cooney@statnews.com

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