Disparities and Health Equity

The differences in ability to access health care and in health outcomes across the population.

Complete Eats: Summer Meals Offered by the Emergency Department for Food Insecurity

Oct. 1, 2019

Danielle Cullen, Abigail Blauch, Morgan Mirth, Joel Fein

Abstract [from journal]

More than 21 million low-income children rely on free or reduced-price meals during the school year. The US Department of Agriculture Summer Food Service Program (SFSP) provides meals to children during the summer months, but these programs are underused. The emergency department (ED) of urban medical centers is 1 of the few establishments that children access during the summer months, and as such, it may be a prime point of entry for such programs. This advocacy case study describes the implementation and evaluation of situating an SFSP in the


Health Care Safety-Net Programs After The Affordable Care Act

Issue Brief
Oct. 1, 2019

Prior to the Affordable Care Act (ACA), health care safety-net programs were the primary source of care for over 44 million uninsured people. While the ACA cut the number of uninsured substantially, about 30 million people remain uninsured, and many millions more are vulnerable to out-of-pocket costs beyond their resources. The need for the safety net remains, even as the distribution and types of need have shifted. This brief reviews the effects of the ACA on the funding and operation of safety-net institutions. It highlights the challenges and opportunities that health care reform presents to safety-net programs, and how they have adapted and evolved to continue to serve our most vulnerable residents.

Mixed Studies Review of Factors Influencing Receipt of Pain Treatment by Injured Black Patients

Sep. 30, 2019

Shoshana V. Aronowitz, Catherine C. McDonald, Robin C. Stevens, Therese S. Richmond

Abstract [from journal]

Aim: To explore the factors that influence provider pain treatment decision making and the receipt of pain management by injured Black patients in the United States.

Design: We completed a systematic mixed studies review using a results-based convergent synthesis design.

Data source: PubMed, SCOPUS, and CINAHL were searched for articles published between 2007-2017 using the search terms "African American", "Black American", "race", "pain treatment", "pain management", and "analgesia".


Nonadherence Labeling in Primary Care: Bias by Race and Insurance Type for Adults With Type 2 Diabetes

Peter Cronholm, MD, MSCE
Sep. 24, 2019

Sourik Beltrán, Lanair A.Lett, Peter F.Cronholm

Abstract [from journal] 

Introduction: Little is known about how provider bias can influence nonadherence labeling. Therefore, a retrospective cohort analysis was conducted to assess the risk of patients with Type 2 diabetes being labeled nonadherent by sociodemographic factors.

Methods: Patients with Type 2 diabetes were identified from 4 primary care sites of the University of Pennsylvania Health System. Demographics, HbA1c, and ICD-10 codes for Type 2 diabetes and nonadherence were extracted from the electronic health


Fast-tracking Behavioral Health Care

Sep. 17, 2019

Imagine struggling with a behavioral health issue, searching for a local psychiatrist, and finding out the provider you’ve chosen doesn’t accept insurance. You wouldn’t be alone: most psychiatrists in the United States don’t. But let’s say your plan has some out-of-network benefits, which means you pay the full cost up front and request an itemized receipt for every appointment.

Racial and Ethnic Differences Over Time in Outcomes of Infants Born Less Than 30 Weeks' Gestation

Sep. 3, 2019

Nansi S. Boghossian, Marco Geraci, Scott A. Lorch, Ciaran S. Phibbs, Erika M. Edwards, Jeffrey D. Horbar

Abstract [from journal]

Objectives: To examine changes in care practices over time by race and ethnicity and whether the decrease in hospital mortality and severe morbidities has benefited infants of minority over infants of white mothers.

Methods: Infants 22 to 29 weeks’ gestation born between January 2006 and December 2017 at a Vermont Oxford Network center in the United States were studied. We examined mortality and morbidity rate differences and 95% confidence intervals for African American and


Constructing a Measure of Health Literacy in Sub-Saharan African Countries

Aug. 22, 2019

Heather F. McClintock, Julia M. Alber, Sarah J. Schrauben, Carmella M. Mazzola, Douglas J. Wiebe


Abstract [from journal]

We sought to develop and evaluate a health literacy measure in a multi-national study and to examine demographic characteristics associated with health literacy. Data were obtained from Demographic Health Surveys conducted between 2006-15 in 14 countries in Sub-Saharan Africa. Surveys were the same in all countries but translated to local languages as appropriate. We identified eight questions that corresponded to the National Academy of Medicine (NAM) definition of health literacy. Factor analysis was used to extract one measure of health literacy.


Recognizing Racism in Medicine: A Student-Organized and Community-Engaged Health Professional Conference

Aug. 12, 2019

Ademide A. Adelekun, Sourik Beltrán, Julia Carney, Lanair A. LettWhitney U. Orji, Emily Rider-Longmaid, Daniel C. Stokes, Stephanie Teeple, and Jaya Aysola

Abstract [from journal]

Purpose: This piece details the evaluation and implementation of a student-led educational intervention designed to train health professionals on the impact of racism in health care and provide tools to mitigate it. In addition, this conference, cosponsored by medical, nursing, and social work training programs, facilitates development of networks of


Overcoming Inequities in Obesity: What Don't We Know That We Need to Know?

Shiriki Kumanyika, PhD, MPH
Aug. 2, 2019

Shiriki Kumanyika

Abstract [from journal]

Efforts to combat the U.S. obesity epidemic have been ongoing in earnest for nearly two decades, informed by a substantial body of knowledge and guided by numerous programmatic and policy recommendations. Yet, although there are some bright spots, I sense frustration in the public health community with the overall lack of clear progress in lowering high obesity prevalence. The fact that something is missing from current approaches is undeniable and must be a continued source of inquiry. This commentary focuses attention on an aspect that is especially