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Utibe R. Essien, MD MPH Profile picture
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1 Dec, 4 tweets, 6 min read
One of the points we made in our article last month (👇🏾) is that #Pharmacoequity extends beyond prescription drug access to the entire therapeutic cascade. A couple of interesting papers led by @ashwin_nathan & @ACFanaroff on TAVRs and #HealthEquity.

jamanetwork.com/journals/jama/…

1/
@ashwin_nathan @ACFanaroff @SameedKhatana @petegroen @jaygirimd @hmartinjulien @bnallamo In @CircOutcomes, the team examined socioeconomic & geographic factors of hospitals that developed TAVR (newer, less invasive treatment for aortic stenosis) programs and found that hospitals serving wealthier patients were ⬆️ likely to start programs.

2/
ahajournals.org/doi/10.1161/CI…
3/3 A month later, the team showed in @JAMACardio that zip codes with ⬆️ rates of Black & Hispanic patients and those with more socioeconomic disadvantages had ⬇️ rates of TAVR, adjusting for age and clinical conditions.

So much to be done in this space.

jamanetwork.com/journals/jamac…
P.S. For more on health disparities in the treatment (including use of TAVR and non-TAVR treatments) and outcomes of aortic stenosis, check out a review from @LarryRJacksonII @KLThomasMD & team in @JACCJournals last year.

Link: sciencedirect.com/science/articl…

#HealthEquity

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More from @UREssien

Utibe R. Essien, MD MPH Profile picture
22 Oct
1/ NEW: Excited to share our Viewpoint in @JAMA_current: "A Policy Prescription for Reducing Health Disparities -- Achieving Pharmacoequity."

A 🧵 on what #Pharmacoequity is, why it should be a public health & policy priority, and how we can achieve it.

jamanetwork.com/journals/jama/…
2/ Ensuring that all individuals, regardless of race & ethnicity, socioeconomic status, or availability of resources, have access to the highest quality medications required to manage their health needs is paramount. This is what we call #Pharmacoequity.

jamanetwork.com/journals/jama/…
3/ The #COVID19 pandemic has brought health equity to the forefront, especially in how we ensure access to novel therapies, from antivirals like #remdesivir and #molnupiravir to the Covid vaccine...

But inequities in access to novel drugs are much more than a Covid problem. 👇🏾
Read 10 tweets
Utibe R. Essien, MD MPH Profile picture
3 Jun
1/
 In 2019, @jared_w_magnani & I were invited to give @PittGIM Grand Rounds on the social determinants of #AFib.

Today, thanks to our incredible co-authors, we published some of those thoughts in Nature! 👇🏾

A 🧵 on gaps & opportunities for future work.

nature.com/articles/s4156….
2/
 The pandemic has taught us so much about our health system, but it has especially shone a bright light on the social determinants as key drivers of #HealthEquity. Our review focused on:
🔸 race/ethnicity
🔸 finances
🔸 rurality/neighborhood
🔸 health literacy
🔸 social network
3/
 The social construct of race has been one of the most well-studied determinants of #AFib incidence, treatment (including our work in anticoagulation disparities), and outcomes. Here we discuss why such inequities exist across the AFib care continuum.

nature.com/articles/s4156….
Read 11 tweets
Utibe R. Essien, MD MPH Profile picture
2 Jun
1/
 Today I received the Larry E. Davis Excellence in Race Research from @PittCRSP.

I met Dr. Davis when I first got to Pitt and was amazed by his fierce & enduring commitment to racial justice. He is greatly missed in our community and I am incredibly honored for this award. 🙏🏾
2/
 I am grateful for my community here @PittTweet, especially the Black Pittsburgh #COVID19 Equity Coalition that has truly been *doing the work* this past year to help keep our communities of color healthy, safe, informed (and now vaccinated) throughout the pandemic.
3/
 I am grateful to so many who have inspired, collaborated with, and taught me so much over the past year, pushing my thinking and scholarship on #HealthEquity, justice, and examining racism as a driver of health in the US, during & beyond the pandemic.

jamanetwork.com/journals/jama-…
Read 4 tweets
Utibe R. Essien, MD MPH Profile picture
1 Jun
1/
 “In 1918, Frissell Memorial Hospital was built at 314 E. Brady St. for Black medical providers to serve Black residents.

The brick building near the bustling Black Wall Street was reduced to rubble and ash during the race massacre three years later.”
tulsaworld.com/persistent-hea…
2/
 “Since then, the healthcare landscape in north Tulsa has mirrored the economic trends, with hospitals and private practices expanding to the south. The perceived inequalities became factual with a report showing ~14-year gap between the north 74126 zipcode and the south 74137” Image
3/
 “In 1920, before the massacre, Greenwood was home to 9,000 Black residents, their medical needs were served by at least 17 doctors, including renowned surgeon, Dr. A.C. Jackson. The neighborhood had its own hospital and 4 well-equipped drugstores...”
wsj.com/articles/in-no…
Read 5 tweets
Utibe R. Essien, MD MPH Profile picture
17 May
1/ Folks have recommended Richard Rothstein’s “The Color of Law” to me for a minute now. Finally had a chance to finish it this weekend.

Absolutely rocked.

The insidiousness of state & federal policy to maintain racial segregation in the US is devastating.

A thread of quotes.
2/ “...said that black students were concentrated in the city, not spread throughout the Detroit suburbs because of ‘unknown and perhaps unknowable factors such as in/migration, birthrates, economic changes, or cumulative acts of private racial fears.’”

wdet.org/posts/2019/11/…
3/ “That the SF region was segregated by policy is striking bc in contrast to other metropolitan areas, Northern CA had few African-Americans before migrants arrived during WWII for jobs. The government was not following pre-existing racial patterns...”
a24films.com/films/the-last…
Read 11 tweets
Utibe R. Essien, MD MPH Profile picture
19 Oct 20
Inpatient Lesson of the Day 7:

I remember the findings from this 2018 @NEJM study that aspirin ⬆️ bleeding risk but didn't ⬇️ CVD risk in the elderly.

What I didn't remember is that "elderly" was defined as >70 for White and >65 for Black/Hispanic.

🧵1/ nejm.org/doi/10.1056/NE…
According to the study Supplement, the following eligibility criteria were provided:

"...the age differential was permitted to ensure that Black and Hispanic populations could be represented in the trial, given evidence of higher burden of disease necessitating aspirin use." 2/
According the study design manuscript, "minority recruitment has been challenging due to a ⬇️ number of minorities w/o prior cardiovascular events, disability or dementia, who are not taking aspirin, and a reluctance to cease aspirin..." 3/
ncbi.nlm.nih.gov/pmc/articles/P…
Read 7 tweets

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