Health Equity & Access Weekly Roundup: April 7, 2025

American Advocacy and Action for Minority Health in 2025

National Minority Health Month this April advocates for effective and equitable care that responds to varying cultural health beliefs, languages, economic and environmental circumstances, and health literacy levels to close the health outcome gap for diverse racial and ethnic populations. This article reminisces on a powerful lecture given at the American Society for Reproductive Medicine Scientific Congress & Expo by Erica E. Marsh, MD, MS, chief of the Reproductive Endocrinology and Infertility Division at the University of Michigan, with renewed relevance following a succession of rapid policy changes since the dawn of the new presidential administration.

The impact on the health and well-being of minority populations, reaching beyond diversity, equity, and inclusion (DEI) rollbacks to stricter immigration policies, increased misinformation, and degradation of social safety nets, has been severe while straining resources, increasing health care disparities, and imposing significant financial burdens on the US health care system, as demonstrated in recent research. Marsh argues that health inequities are driven more by social constructs than biology and calls for diverse communities to speak up through "counter storytelling" to reclaim narratives and challenge dominant systems.

High-Impact Trials at ACC.25 Signal Shift in Chronic Disease Treatment

At the American College of Cardiology Annual Scientific Session, leaders in cardiology presented compelling new research with the potential to transform cardiovascular care, especially for women and patients with cardiometabolic conditions. Key highlights included strong clinical trial data supporting the use of glucagon-like peptide-1 and sodium-glucose cotransporter 2 inhibitors—particularly oral semaglutide—for reducing cardiovascular risk and treating peripheral artery disease, which had a notable spotlight at the meeting. The SOUL, STRIDE, WARRIOR, and DapaTAVI trials were among those acknowledged by experts for advancing care in historically underserved or complex populations. Experts also emphasized the urgent need for better treatment models for women with conditions like ischemia with no obstructive coronary arteries and praised the overall quality of randomized controlled trials presented, signaling a shift toward more preventive, personalized, and evidence-based cardiovascular strategies.

11% of Americans Cannot Access Quality Health Care, Survey Finds

According to the West Health-Gallup Healthcare Indices Study, around 29 million US adults—11% of the population—are now considered "cost desperate," meaning they cannot afford or access quality health care. This crisis is worsening, especially among Hispanic and Black communities and households earning less than $24,000 per year, where significant increases in cost desperation and declines in "cost secure" status have been observed since 2021. Rising health care costs, which continue to outpace inflation, have further widened disparities in access across race, ethnicity, income, and age. While wealthier and White Americans remain relatively unaffected, the number of Americans unable to access affordable, quality care reached 35% in 2024—its highest level since 2021. Experts warn that without urgent state and federal policy action, more Americans will forgo treatment or face difficult trade-offs between health care and basic needs.

Robert F. Kennedy Jr Faces Senate Inquiry Over Deep Cuts to HHS Impacting FDA, CDC, NIH, CMS

Robert F. Kennedy Jr, as HHS secretary, faces scrutiny and criticism for his extensive reorganization of the department, which includes massive layoffs affecting up to 10,000 employees, alongside early retirements and voluntary separations. These cuts, amounting to nearly a quarter of HHS staff, are part of a broader effort to streamline government operations, according to the White House. Despite Kennedy's aim to enhance efficiency, the restructuring has sparked significant concern among experts and lawmakers alike. Critics fear detrimental impacts on public health, biomedical research, and regulatory capabilities at agencies like the National Institutes of Health, FDA, CDC, and CMS. The upcoming Senate hearing, scheduled for April 10, will aim to address these concerns and seek clarity on the administration's strategy moving forward.

Freeze in International Funding Could Significantly Reverse Progress in HIV Treatment

A new study warns that upcoming reductions in US and international HIV funding could reverse global progress against the epidemic, especially in sub-Saharan Africa, by 2030. The US, which provides over 70% of international HIV aid—largely through the US President’s Emergency Plan for AIDS Relief (PEPFAR)—is set to implement significant funding cuts alongside other donor nations. Using the Optima HIV model across 26 low- and middle-income countries, researchers projected that if PEPFAR is discontinued without mitigation, up to 10.75 million new infections and 2.93 million HIV-related deaths could occur by 2030, potentially returning infection and death rates to levels seen in 2010 or earlier.