J Natl Med Assoc
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Current projections anticipate a dramatic shift from historical population demographics in the United States. Racial and ethnic minorities are expected to constitute the majority of the population by 2050. However, racial minorities continue to be underrepresented in medical school admissions and the physician workforce. Creating a medical student and physician workforce that reflects population demographics of their patients will be an important determinant in promoting public health and health equity. ⋯ The authors call on medical students across the country to join in pursuit of health equity and a diverse physician workforce that reflects the evolving demographics of the United States. Medical students can impact the health of local communities through implementation of educational outreach programming to facilitate access to medical education for middle and high school students.
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There is very limited comprehensive information on disparate outcomes of black and white patients with COVID-19 infection. Reports from cities and states have suggested a discordant impact on black Americans, but no nationwide study has yet been performed. We sought to understand the differential outcomes for black and white Americans infected with COVID-19. ⋯ Despite the initial descriptions of COVID-19 being a disease that affects all individuals, regardless of station, our data demonstrate the differential racial effects in the United States. This current pandemic reinforces the need to assess the unequal effects of crises on disadvantaged populations to promote population health.
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In the United States, it is estimated that 2.4 million people are currently infected with the hepatitis C virus (HCV). In order to address HCV infection management in the U.S., several government entities collaborated to develop and release a multistep plan for the prevention, care, and treatment of viral hepatitis. Optimal health outcomes from the plan are contingent upon addressing each of the several steps in the HCV care cascade. Among the critical challenging steps is linkage to care and access to treatment. Of the nearly three million people in the U.S. infected with HCV, only 43% have been linked to care, 16% have received treatment, and 9% have had their infection resolved. ⋯ HCV infections remain a major public health concern among patients in the District of Columbia. This study identified fibrosis stage and prior insurance denial as primary barriers to access of HCV treatment. While there are many points in the hepatitis cascade of care in which patients can lose access to or fail treatment completion, the primary point of intervention in our patient population appears to be during the initiation of treatment and insurance prior authorization process.