Health Equity & Access Weekly Roundup: November 16, 2024

How English- and Spanish-Preferring Patients With Cancer Decide on Emergency Care

A qualitative study examined the views of patients with newly diagnosed cancer who visited emergency departments (EDs) at 2 health care systems in Dallas, Texas. Findings showed many patients were unaware of available services like 24/7 oncology triage and urgent care clinics despite their existence. Decision-making was often driven by fear and uncertainty about symptoms, particularly among safety-net patients who relied more on EDs due to limited outpatient support. Patients valued the ED's accessibility and comprehensive care, and their positive experiences often led to repeated ED visits. Communication gaps, especially for Spanish-preferring patients, revealed disparities in care access, underscoring the need for better education and outreach to reduce unnecessary ED visits.

Financial, Psychological Burden of Abortion Care in US Raises Calls for Expanded Insurance

A recent cross-sectional study highlighted the substantial financial and psychological burdens faced by patients seeking abortion care in the US, especially those traveling out of state due to local restrictions or limited clinic availability. Conducted before the Dobbs decision, the study found that 42% of participants incurred catastrophic health expenditures (CHEs), with out-of-state patients 3 times more likely to face these costs compared with in-state patients. Out-of-state travel also correlated with higher rates of anxiety and depression. The findings emphasize the need for expanded insurance coverage and policy reforms to address both direct and indirect costs, such as transportation and accommodation, which disproportionately affect low-income patients.

STI Epidemic May Be Slowing, CDC Data Suggest

New CDC data show signs of progress in slowing the sexually transmitted infection (STI) epidemic in the US, with a 1.8% overall decline in cases from 2022 to 2023, marking the first major reversal after nearly 2 decades of increases. Gonorrhea cases dropped by 7.2%, and primary and secondary syphilis cases decreased by 10.2%, although total syphilis cases rose slightly, and congenital syphilis cases increased by 3%. Despite these gains, over 2.4 million STI cases were reported, including significant disparities by age, race, and sexual orientation, with young people, men who have sex with men, and racial minorities disproportionately affected. Public health leaders emphasized the importance of addressing inequities in sexual health care and investing in prevention strategies to sustain this momentum.

Young Adults With Low Incomes Have Higher Diabetes Mortality Risk

A South Korean cohort study revealed that young adults with type 2 diabetes and low income face significantly higher mortality risks, particularly from cardiovascular causes, compared with their higher-income peers, with disparities most pronounced in individuals under 40. Low-income young adults were nearly 3 times more likely to die from any cause, partly due to poorer medication adherence, lower participation in preventive health measures, and higher rates of smoking and inactivity. Despite similar health care access under South Korea’s universal system, income remained a critical factor influencing outcomes, emphasizing the need to address socioeconomic barriers to improve survival and health equity in this vulnerable population.

Underdiagnosis of Hidradenitis Suppurativa May Link to Socioeconomic Factors

A study published in the Journal of the American Academy of Dermatology highlighted potential underdiagnosis of hidradenitis suppurativa (HS), particularly in populations with lower socioeconomic status. Using data from the NIH’s All of Us database, researchers found higher prevalence rates of HS among Black individuals, women, those younger than age 65, and people with lower income and education levels. Smoking, e-cigarette, and hookah use were also linked to increased HS risk. Lower rates among uninsured and unemployed individuals suggest potential underdiagnosis due to reduced health care access. The findings underscore the need for timely diagnosis and tailored prevention strategies to address disparities and improve outcomes for vulnerable populations.