J Natl Med Assoc
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The hypothesis that marijuana availability reduces opioid mortality merits more complete testing, especially in a country with the world's highest opioid death rate and 2nd highest cannabis-use-disorder prevalence. ⋯ Instead of supporting the marijuana protection hypothesis, ecologic associations at the national level suggest that marijuana legalization has contributed to the U.S.'s opioid epidemic in all major races/ethnicities, and especially in blacks. If so, the increased use of marijuana during the 2020-2022 pandemic may thereby worsen the country's opioid crisis.
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Gastrointestinal cancers account for a significant burden of cancers in the United States. We sought to measure relative incidence of and mortality from the five most common gastrointestinal malignancies by race and ethnicity. ⋯ Liver and gastric cancer have the greatest differences in incidence and mortality by race/ethnicity. Non-Hispanic Black individuals carry the highest burden of gastrointestinal malignancies overall.
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There has been increased focus on health disparities and how to address them (Baciu et al., 2017; National Institutes of Health, 2021; Williams et al., 2021). Greater integration of social determinants of health (SDoH) education into undergraduate medical education has been identified as one possible intervention (Mangold et al., 2019; Doobay-Persaud et al., 2019; Lewis et al., 2020). The Liaison Committee on Medical Education places this education among its accreditation requirements (Mangold et al., 2019); however, no consensus exists on the most effective programming for training culturally competent physicians. ⋯ In 2020, the program was expanded and integrated into the broader curriculum. Here, we present WUMP, an example of one approach to SDoH training for medical students that was grounded in the local political and social context of St. Louis and prepared students to learn, train, and practice within that context.