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Study on racial health disparities called into question

October 23, 2024
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Morning Rounds Writer and Podcast Producer

Does anyone here listen to Who Weekly? They sort celebrities into "Whos" (the not-as-famous) and "Thems" (the universally-well-known). So, like: RFK is a Them, while Casey and Calley Means are Whos. The study below on sense of smell and breathing made me think: What's the Who-to-Them ranking of the five senses? First I thought smell was the Whoiest, but my editor wisely suggested touch as the sense people most often forget. Sight is the Themiest, obviously.

(Please tell me this makes sense to someone?)

racial health disparities

A major study on infant survival and physician race is called into question

Adobe

In 2020, a high-profile study in the Proceedings of the National Academies of Science found that Black infants were half as likely to survive to their first birthday when cared for by white doctors compared to Black ones. But a new analysis published in the same journal upends those results. Researchers found that the survival difference in the original study was almost entirely attributable to infants' very low birth weights. Physician race still appears to play some role in infant survival, but not a statistically significant one. 

This follow-up was possible because the original researcher, Ben Greenwood, shared his data. "We encouraged them to study this because it's so important," said Greenwood. "I don't think it's helpful to be defensive about your work." Read more from STAT's Usha Lee McFarling.


head injuries

Early research on a new concussion sign to look out for 

You probably know some of the classic concussion signs to watch for: Did the person lose consciousness? Appear dazed or confused? Have a change in mood? Research published this morning (like just now at 6 am ET) in Diagnostics has identified a new potential signal: "the spontaneous headshake after a kinematic event," or SHAAKE. 

You've seen people do this — it's quick, like they're shaking sand off their head. The study surveyed almost 350 people from a concussion database, showed them videos of athletes doing this, and asked: "Do you remember ever making this type of head motion after a collision?" Most participants were in their mid-twenties, responding about incidents that happened in high school or college. Of course, this isn't the most rigorous study model — more research will be needed to see how accurately the movement signals a concussion. But in the study, 69% of respondents reported a SHAAKE, and 93% of those reported one in association with concussion at least once.


public health

How homelessness and health are intertwined

The Georgia State University School of Public Health announced yesterday that it will open a Center on Health and Homelessness in Atlanta. Only a small number of academic institutions have programs focused on the intersection of health and housing, including USC, Harvard, and NYU

Research at institutions like these has highlighted that increasing the availability of affordable housing is one of the best ways to reduce homelessness. Still, many lawmakers have turned to actions like encampment sweeps

The announcement caught my eye because I was recently reminded of an old STAT story by Bob Tedeschi. In 2016, he spent time with 68-year-old Dwane Allen Foreman. Foreman was homeless and had HIV, hepatitis C, chronic obstructive pulmonary disease, and lung cancer. He worried about dying on the street. "I would like to just live a little longer, that's all," he told Bob. "Enjoy whatever life has left for me."

Foreman died just eight months later. That was eight years ago, but it's hard to say how much has changed for unhoused people in the U.S. struggling to get health care.



election corner

What Trump's connections to Project 2025 mean for health care

Spencer Platt/Getty Images 

Donald Trump has sought to distance himself from Project 2025. But the New York Times reported yesterday that out of 307 authors and contributors to the document, more than half have served in Trump's administration or been part of his campaign or transition teams.

What do these connections mean for health care policy if there's a second Trump presidency? Over the summer, a team of STAT reporters (myself included) explored how Trump's statements on health policy stack up against the plans laid out in Project 2025. We covered Trump's proposals on drug pricing, gender-affirming care, addiction and the overdose crisis, chronic illness, reproductive care, and more. 

"The first and best source of what a future Trump administration would want to do — I'm not telling you anything shocking here — is the former president himself," said former Trump adviser Theo Merkel. Read more.


science

People who can't smell may breathe differently 

Would you rather give up your sense of smell or your cell phone? A 2022 paper found that one-quarter of college students, and 15% of the general public, said that they would choose their trusty devices over their olfactory abilities. But people who have anosmia, the loss of smell, are more often depressed, experience muted emotions, have dietary complications, and literally aren't able to sniff out dangers like smoke — outcomes that actually result in a reduced life expectancy. A study published yesterday in Nature attempted to illuminate the cause of these associations. 

After observing the nasal airflow of 21 people who couldn't smell and 31 people who could, researchers found that people who couldn't were breathing differently both while awake and asleep. People who can smell had many more of small "inhalation peaks" per hour while awake — likely meaning they were doing some "exploratory sniffing," the authors wrote. 

More long-term research is needed, as the study only observed participants for 24 hours. But this is "potentially a profound difference in brain activity," the authors write. And based only on the breathing data, the team was able to predict which participants could smell with 83% accuracy.


food

Dietary experts plan for next five years of guidelines

How should Americans be eating? Scientific experts tasked with advising federal officials on updated dietary guidelines had their final meeting this week to discuss their recommendations, which will be published in December. STAT's Liz Cooney had some takeaways:

  • The data on ultra-processed foods are too limited to draw conclusions. Experts said they'll advise skipping any recommendations on these oft-criticized food products — for now. "Ultra-processed foods are not going to be an issue that goes away," Deirdre Tobias of Harvard University said. "I think in the next five years, research is going to explode. In five years, hopefully this isn't sort of punted again." Read more on the first day's discussions.
  • No major overturn, but guidelines should emphasize plant-forward diets. We've known since the '80s that saturated fats are bad for us, but only about 1 in 5 Americans successfully limit the amount they consume. But it's not as simple as emphasizing one type of meat over another, experts said. "If we want to make a meaningful difference," said Christopher Gardner of Stanford University, "choosing leaner or the lower-fat version isn't going to get us there." So what to do? Read more on the conclusions from day two.

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Thanks for reading! More tomorrow,


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