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The impact of taking race out of a lung function test

May 20, 2024
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Chronic disease reporter

G'morning! I'm chronic disease reporter Isa Cueto, filling in for Theresa, who's off sipping on a coconut. This weekend, Digestive Disease Week kicked off in D.C. I stopped by to check it out. If you're there, let me know what's caught your eye: isabella.cueto@statnews.com.

health equity

Removing race from a lung function equation could have 'profound' impacts

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Adobe

For decades, health equity advocates have questioned the validity of a race-based adjustment to lung function tests. In some cases, readings were adjusted by as much as 15% for Black patients, making their illness seem more mild. Removing race from that equation could reclassify nearly half a million Black Americans as having more severe lung illness, and increase demand for pulmonary care, according to a study published Sunday in the New England Journal of Medicine.

Last year, the American Thoracic Society said the racial correction in lung tests should end. Here's what that would look like, according to findings presented at the society's annual meeting in San Diego: An additional 2.64 million people, most of them Black, Hispanic, or white, would be diagnosed with obstructive lung disease (asthma or COPD). The number of Black people diagnosed with moderate to severe COPD would increase to 428,000. The change would lead to some "tradeoffs" — better access to certain treatments, and increased disability payments to Black veterans, but also ineligibility for jobs that require healthy lungs, for example. STAT's Usha Lee McFarling has more.


health care costs

Crowdfunding for medical care taps into the 'impossible rat race of needing'

We've all been confronted by it: someone online pleading for donations to help cover their medical expenses, or those of a friend or relative. Just this month, I had the horrible task of editing text for a family member's fundraising page after an unexpected hospitalization. For many, crowdfunding sites can seem like a godsend in a system that frequently bankrupts people in medical emergencies. But it also comes with some downsides, says Nora Kenworthy, a nursing and health studies professor at the University of Washington, Bothell, in an interview with STAT's Nalis Merelli.

"There's a way in which crowdfunding thrust upon all of us an impossible set of choices," Kenworthy said. "We exist within this completely broken system, and apparently, the way that we're going to address it is by giving 20 bucks to people's GoFundMe campaigns. And, now you as a consumer have to choose who gets your $20 — it's this impossible rat race of needing." Read the rest of the interview here.


addiction

People with opioid use disorder are still getting blocked from treatment

If you're an attentive STAT reader, you know how the U.S. is sabotaging its best tools in the fight against the opioid epidemic. As my colleague Lev Facher has reported in his series, "The War on Recovery," barely one-fifth of the roughly 2.5 million Americans with opioid use disorder receive treatment, and tens of thousands of people have died. 

Two new studies offer more details on what's keeping Medicaid patients from buprenorphine. The first, a cross-sectional study of Medicaid pharmacy claims data from six states, found buprenorphine was inaccessible in up to 20% of community retail pharmacies in 2019 — even in pharmacies that dispensed other opioids. The second study found that adding to the list of clinicians who could prescribe buprenorphine increased Medicaid beneficiaries' access to treatment from 2017 to 2021. But almost a third of clinicians still said they didn't prescribe the medication "due to a lack of supervision, mentorship or peer consultation." 

(As a bonus, here's a recap of Lev's addiction panel that took place at STAT's Breakthrough West Summit last week.)



first opinion

HHS's silence on health care's contribution to climate change is deafening

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Christine Kao/STAT

The U.S. healthcare system produces nearly 5% of global greenhouse gas emissions, and massive amounts of air pollution. It leads all other nations in its health care-related emissions. But you probably wouldn't know that based on how the health care system acts, climate policy consultant David Introcaso writes in a new First Opinion

A recent proposal from the U.S. Department of Health and Human Services — more specifically, the Centers for Medicare & Medicaid Services — would give certain hospitals the chance to voluntarily report their emissions over the course of five years. The proposal is a "regulatory illusion intended to accomplish nothing," Introcaso writes. "Climate nihilism" is common across health care, and groups that should support better regulation of emissions avoid the issue completely. He argues that HHS can be tougher on emissions, including by requiring hospitals to publicly report their emissions each year. Read more


vaccines

HIV vaccine history is riddled with failures. Could a new approach work?

Immunologists have been trying for decades to develop an effective vaccine against HIV, with no success. Just last year, researchers' last attempt to get an HIV vaccine off the ground in this decade was shut down; the vaccine regimens were a dud. HIV is famously a shapeshifter, mutating at the highest rates known to science. That makes it really difficult for the human immune system to catch up and shut the virus down. 

So it's with great skepticism (and hope) that researchers are testing a new approach, STAT's Annalisa Merelli and Jonathan Wosen report. Last week, four studies bolstered the idea that exposing the immune system to a series of different vaccine molecules could trigger a powerful and protective antibody response. The studies, conducted in mice and monkeys, showed that researchers could begin to coax an exceedingly rare kind of B cell to make antibodies that block a broad swath of viral strains — an important first step. But there are still plenty of barriers to making this work in people. Read more.


research equity

She works hard for the money

Over the last few decades, there's been a solid upward trend in the number of women scientists in the life sciences. In the mid-'80s, around the same time Donna Summer released that chart-topping banger, less than 40% of doctorate recipients were women. That number is about 55% now. And NIH funding has largely followed that same trajectory (a little over 10% of NIH funding was awarded to women in 1985). Good news all around for gender parity. 

Except. Some studies still point to stubborn funding discrepancies when controlling for a bunch of other factors. A new paper analyzed the distribution of 2.3 million NIH grants awarded in biomedicine from 1985 to 2017. The researchers found that while women scientists as a whole have been awarded more grant resources over time, the gains are unequal. The change over time "disproportionately benefits senior women scientists, while leaving other, junior women scientists behind," the authors write. 


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