In December, the @American_Heart published a Presidential Advisory statement on working against structural racism and health disparities in response to recent news events and #BLM advocacy. #healthequity#CQOSpotlight
The writing committee on behalf of the @American_Heart in the second sentence of the abstract cite COVID-19, George Floyd, Breonna Taylor as recent examples of structural racism, health disparities for disenfranchised groups.
The statement provides a background on why these issues are relevant to cardiovascular health and the importance of eliminating structural racism.
The AHA statement discusses the persistent CVD health disparities, especially for Black Americans.
Direct statements highlight the source of observed inequities from structural racism in relation to health. With a further discussion of social determinants of health.
As a reminder of wealth inequalities in the U.S., this is a plot of median wealth by age stratified by race (white/Black)
The AHA statement provides historical context and also diagrams major historical institutions and policies that disenfranchised Blacks.
AHA has published statements previously attempting to provide a large overview of current challenges and health disparities. This statement references prior statement focused on Black, Hispanic, Native and Asian American CVD health.
Atherosclerotic Cardiovascular Disease in South Asians in the United States: Epidemiology, Risk Factors, and Treatments: A Scientific Statement From the American Heart Association
AHA's organized strategy to address structural racism
While AHA has written reports regarding health disparities with similiar ambitious goals, the tone and directness of the recent statement focuses primarily on structural racism, which is a welcome change, yet, an immense challenge.
For additional historical perspective and the potential remediation of structural racism for Black Americans, I suggest Ta-Nehisi Coates @TheAtlantic piece from 2014
It is interview season for medical fellowships and I thought I would take the time to discuss some of the issues I see come up recurrently in evaluating applicants, especially in dedicated physician-scientist research programs.
I am fortunate to have graduated from @UCLA ’s STAR program which feel is an incredible model for training physician-scientists.
Most MD-PhD programs in the U.S. are funded by the @NIH MSTP program which integrate research and medical education. MSTP funds 50 programs and supports ~1000 trainees annually. nigms.nih.gov/training/instp…
“‘We do tend to trust our authors,” Dr. Rubin said. “All journals do.” Both editors pointed out that Dr. Mehra had signed statements indicating he had access to all of the data and took responsibility for the work, as did other co-authors.”
How did Surgisphere generate the publication data?
To simulate each observation (n=96,032) he'd have to know how to distribute all the characteristics and adjust them as needed.
To falsify tables, he'd have to account for counts carefully and generate confidence intervals and other statistics as a best guess from other papers while making sure things were fairly consistent.
@mikejohansenmd@NEJM@TheLancet@ADAlthousePhD Now look at the reference group 0-10: the figure claims that 11-20 and 21-30 year-olds have a lower risk of death relative to kids <10. Well if that’s true it should be the headline of the @NEJM study.
Let me take us all on a magical walk through the @Surgisphere "revision" and explanation given to the @lancet. Not everything looks like what it seems. I would hope @richardhorton1 would have pushed for better explanations.
Let us start with the correction statement. One hospital from Australia should have been in Asia. Not sure why a hospital a company sold a product to would need to self-identify for a cloud-based data analytics platform:
They also notify us that the original table S3 was corrected and the lack of variation was because they presented "propensity matched and weighted" tables rather than raw estimates.
"The overall probability of death among those infected (the Infec-tion Fatality Ratio, IFR) is 0.7% (95% CrI: 0.4–1.0), ranging from 0.001% in those under 20ya to 10.1% (95% CrI: 6.0–15.6) in those >80ya (Fig. 2D and table S2)."
"We find that the basic repro-ductive number R0 prior to the implementation of the lock-down was 2.90 (95% CrI: 2.80–2.99). The lockdown resulted in a 77% (95% CI: 76–78) reduction in transmission, with the reproduction number R dropping to 0.67 (95% CrI: 0.65–0.68)."