Access to Medicare may help address racial disparities in insurance coverage, access and self-reported outcomes, according to a new study (Source: “Medicare eligibility erases many healthcare disparities in US,” Healthcare Dive, July 26). The ...
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Ohio Health Policy News 07/30/2021


Medicare eligibility drives down racial disparities, study finds

Access to Medicare may help address racial disparities in insurance coverage, access and self-reported outcomes, according to a new study (Source: “Medicare eligibility erases many healthcare disparities in US,” Healthcare Dive, July 26).

The research, published in JAMA Internal Medicine, tracked more than 2.4 million Americans and found that immediately after turning 65, and thus becoming eligible for Medicare, coverage for Black respondents increased from 86.3% to 95.8%. Among Hispanic respondents, coverage increased from 77.4% to 91.3%.

The JAMA study has validated the importance of Medicare in terms of leveling the playing field for Americans when it comes to healthcare access — a gap that has been exacerbated by the COVID-19 pandemic. Whereas there are significant gaps in access to healthcare and disparities among ethnic groups, reaching Medicare age wipes much of them out.

Disparities in insurance coverage were cut by 53% between Black people and white people, and 51% for Latino people versus white people. The proportion of Black and Latino people who self-reported their health as poor also dropped significantly after they became eligible for Medicare.

        
 

Organizations aim to connect patients, therapists of color

A number of new organizations aim to digitally connect patients with mental health providers who value and understand different cultures (Source: “It’s Hard to Search for a Therapist of Color. These Websites Want to Change That.,” New York Times, July 16).

In recent years there has been an expanding number of digital companies and nonprofits created to help people of color find a therapist they can trust — someone who is not only skilled in the best evidence-based treatments but also culturally competent. In other words, a provider who is aware of their own world views, knowledgeable about diversity and trained to connect with different types of clients.

The founders of these organizations say there has always been a need for such services, and even more so now that people are coping with the stressors of the pandemic and the racial reckoning that followed the killing of George Floyd by the Minneapolis police.

Studies have shown that mental health treatments can be more effective when a client feels that their therapist values culture.

It can be difficult for people of color to locate a therapist with a shared cultural background.  An American Psychological Association report found that only 5% of psychologists are Hispanic and 4% are Black — 86% are white. A similar disparity exists among the country’s social workers and psychiatrists.

        
 

Study finds link between neighborhood disadvantage and COVID-19 disparities

New research has found a strong link between COVID-19 and neighborhood disadvantage, a finding that supports earlier contentions of the connection between social factors and coronavirus disparities (Source: “How Neighborhood Disadvantage Drove COVID Health Disparities,” Patient Engagement HIT, July 21).

The study examined the connection between COVID-19 inequity and subway ridership in New York City. Neighborhoods that ranked higher on a COVID-19 inequity index — meaning that the neighborhood saw more factors that could put inhabitants at risk — also had higher subway ridership even after COVID-19 forced city-wide shutdowns.

Daniel Carrión, a researcher from Mount Sinai, said needing to ride the subway — or work an essential job — had a strong link to the unequal infection rates seen during the height of the coronavirus pandemic, largely because it limits the ability to socially distance.

“For us, subway utilization was a proxy measure for the capacity to socially distance,” Carrión, a postdoctoral researcher in the Department of Environmental Medicine and Public Health at the Icahn School of Medicine, told PatientEngagementHIT in an interview.

Although public health experts have made the link between the social determinants of health leading to actual infection, not just poor outcomes, Carrión and his colleagues put some data behind that. Social disadvantage was linked with higher subway utilization, and ultimately to higher infection rates and starker disparities.

“Folks like me were able to stay home for the majority of the pandemic and work from home. I didn't need to use public transit whereas others did. What we found was that areas that had higher COVID inequity indices were also riding the subways more after the stay-at-home orders compared to folks that were low in the COVID inequity index.”

        
 

Low number of Black dermatologists could hurt quality of care, providers warn

For people of color, basic dermatological conditions sometimes go undiagnosed or misdiagnosed by doctors unfamiliar with treating darker skin, healthcare professionals say (Source: “Skin color matters: In dermatology, patients' diversity calls more Black doctors,” Columbus Dispatch, July 29).

According to a June 2017 study published in the Dermatology Journal of the American Medical Association, 3% of dermatologists in the United States were Black. In 2020, 13.4% of the U.S. population was Black or African American, according to the U.S. Census.

A lack of diversity in any medical field can hurt the quality of care given. And a doctor from one ethnic or racial background might be able to offer information not necessarily taught in school.

        
 

Opiate settlement could mean $1B for Ohio treatment, prevention programs

Ohio and other states reached a $26 billion settlement with the three largest drug distributors as well as manufacturer Johnson & Johnson that is expected to surge cash into opioid treatment and prevention programs (Source: “Ohio could get $1B from multibillion dollar deal with opiate maker and three distributors,” Columbus Dispatch, July 21).

Ohio's cut of the cash could hit $1.03 billion if local jurisdictions sign onto the agreement, according to Ohio Attorney General Dave Yost's office.

The agreement comes after nearly four years of negotiations. Under the settlement, J&J will pay up to $5 billion over nine years and the three distributors — McKesson Corp., AmerisourceBergen and Ohio-based Cardinal Health Inc. — will collectively pay up to $21 billion over 17 years. 

In March 2020, Yost and Gov. Mike DeWine announced that local governments had signed off on a plan on how opioid settlement money would be divvied up. The OneOhio agreement calls for 30% of the money to be earmarked for community recovery programs at the local level, 55% for a statewide foundation and 15% to the state.

        
 

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