Share this page!

Enter URL or ID to Unroll

You can paste full URL like: https://x.com/threadreaderapp/status/1644127596119195649
or just the ID like: 1644127596119195649

How to get URL link on X (Twitter) App

  1. On the Twitter thread, click on or icon on the bottom
  2. Click again on or Share Via icon
  3. Click on Copy Link to Tweet
  4. Paste it above and click "Unroll Thread"!
  5. More info at Twitter Help
Utibe R. Essien, MD MPH Profile picture
@UREssien
Sep 7, 2022 • 8 tweets • 9 min read • Read on X
Scrolly
1/ 🧵 NEW Editorial.

In the latest issue of @JAMA_current, my mentor Michael Fine, Donna Washington and I were invited to discuss a new 📝 on disparities in SGLT2i and GLP1-RA use for diabetes and what it means for the field of #Pharmacoequity research.

jamanetwork.com/journals/jama/… ImageImage
2/ As has been discussed frequently over the last month with the insulin co-pay provisions in the #InflationReductionAct, >37 million people in the US have #diabetes.

Regrettably, underrepresented racial and ethnic groups folks have ⬆️ rates of diabetes.

jamanetwork.com/journals/jama/… Image
3/ Even with the ⬆️ rates of diabetes, Black, Hispanic, and Asian patients in the US have been shown to have lower rates of #diabetes treatment, especially with the newer drugs available such as SGLT2i & GLP1-RAs.

SGLT2: jamanetwork.com/journals/jaman…

GLP1: jamanetwork.com/journals/jama-… ImageImage
4/ And so @jlampre & team wanted to see if similar disparities exist in VA.

TL;DR: Patients of several different racial groups & those of Hispanic ethnicity had ⬇️ odds of receiving SGLT2i & GLP1-RA therapies.

jamanetwork.com/journals/jama/…

@Peralta_KHRC @Ndichu_Muiru @LTummalapalli Image
5/ We note that “to truly achieve #Pharmacoequity, we need 3rd-generation research that develops, evaluates & implements evidence-based interventions to eliminate disparities and 4th-generation research that directs action against the structural determinants of unequal care...” ImageImage
6/ We also highlight that while the disparities described by @jlampre et al. are key, this is a regrettably common phenomenon:

New 💊 comes out, individuals from communities of color are last in line to receive them.

From diabetes and #AFib to #COVID19.

jamanetwork.com/journals/jama/… Image
7/ My hope is that as we move closer towards achieving #Pharmacoequity, through research like the latest in
JAMA, but especially through policy changes to enhance access, reduce cost, eliminate bias, and improve quality of 💊 care, we can ⬇️ disparities.

jamanetwork.com/journals/jama/… Image
8/8 Finally, the opportunity to write this piece was a true *ikagai* moment.

Hard to imagine that a year from introducing #Pharmacoequity, I would read it in the 1st sentence of a JAMA article. 🙏🏾

Grateful to the village around supporting this work. 👊🏾

jamanetwork.com/journals/jama/… ImageImage

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with Utibe R. Essien, MD MPH

Utibe R. Essien, MD MPH Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @UREssien

Utibe R. Essien, MD MPH Profile picture
Apr 17, 2023
1/ 🧵 NEW Paper.

We asked: Are there racial & ethnic differences in barriers to applying to & enrolling in med school and do those affect med school diversity?

TL;DR: Black & Hispanic students were less likely to apply & enroll and faced more barriers.

jamanetwork.com/journals/jama-… ImageImage
2/ First, who did we study?

This was a study of >81,000 MCAT examinees (0.3% American Indian or Alaska Native, 21.3% Asian, 10.1% Black, 8.0% Hispanic, and 60.4% White) from 2015-2018.

I don’t know about y’all, but this was *the* hardest test I took. 😳

jamanetwork.com/journals/jama-… Image
3/ Next, what did we find?

1️⃣ Black (77.8%) & Hispanic examinees (71.3%) were ⬇️ likely than White examinees (80.2%) to apply to med school.

Black (40.6%) & Hispanic examinees (40.2%) were also ⬇️ likely than White examinees (45.0%) to matriculate.

jamanetwork.com/journals/jama-… Image
Read 12 tweets
Utibe R. Essien, MD MPH Profile picture
Sep 8, 2022
Wow. 😧

If y’all read *one* thing today, might I suggest this new article in @NEJM?

“The belief that Black people have denser bones, more muscle, or thicker skin led radiologists and technicians to use higher radiation exposure during x-ray procedures.”

nejm.org/doi/full/10.10…
I had no clue about this history... Curious if others did?

cc @uche_blackstock @oni_blackstock @ushamcfarling @LundyBraun @ruha9 @DarshaliVyas @haw95 @DrAlethaMaybank @AmakaEMD @CamaraJones @AMLandryMD @DrRayMD @ElohoUfomata @gr8vision @DrJRMarcelin @gradydoctor @AmberJohnsonMD
For folks interested in learning more of this history, see the excellent thread from 1st author @ibavli: 👇🏾


cc @arghavan_salles @meganranney @jeremyfaust @FutureDocs @ETSshow @MDaware @GYamey @Bob_Wachter @EugeneDaniels2 @LizSzabo @RoniNYTimes @choo_ek
Read 5 tweets
Utibe R. Essien, MD MPH Profile picture
Jul 27, 2022
‼️ NEW Paper ‼️

In @JAMANetworkOpen, we found that VA patients with #AFib who experience homelessness had a 21% ⬇️ odds of receiving stroke-preventing anticoagulation (blood thinners).

Here's more on our journey to this #Pharmacoequity paper.

Link: ja.ma/3ODXdss

1/
Previously, if you looked up "homeless & atrial fibrillation" in PubMed, only 5 results came up.

This included a 2003 @JAMAInternalMed study that saw that Ohio Medicaid enrollees had ⬇️ use of warfarin if they had homelessness or inadequate housing.

ja.ma/3PFwj52

2/
We started digging into this in 2019, when 1st author, David Wilson, a PittMed student & Veteran, met with me for a summer research project.

We decided to use our national #AFib cohort to see if there was a relation b/w homelessness & AF treatment.

ja.ma/3ODXdss

3/
Read 12 tweets
Utibe R. Essien, MD MPH Profile picture
Jul 25, 2022
1/ 🧵 NEW Paper!

As part of a special issue on 💊 costs & access, we wrote a broad review on “Pursuing #Pharmacoequity - Determinants, Drivers, and Pathways to Progress.

We talk social & health policy, research, patient & prescriber factors. 👇🏾👇🏾

Link: tinyurl.com/nvtamek8 Image
2/ Understanding the multilevel determinants that influence equitable access to medications (and trying to do so in <5000 words (!) was the goal of our review.

With so many factors out there, we know we only began to scratch the surface.

read.dukeupress.edu/jhppl/article/…

#Pharmacoequity Image
3/ A few topics we discussed:

🔴 Public transportation & geographic access to pharmacies

🔴 Income and wealth inequities

🔴 Research representation

🔴 Health insurance coverage (e.g., ACA & Medicare Part D)

🔴 Clinician bias & trustworthiness

🔴 Patient primary language
Read 6 tweets
Utibe R. Essien, MD MPH Profile picture
Feb 10, 2022
1/ 🧵 Out today in @Health_Affairs.

On #Pharmacoequity and equitable access to novel #COVID19 treatment.

Led by future Dr. @rohankhaz, we dive into the challenges & opportunities in ensuring that patients and communities most affected by the pandemic can get the care they need.
2/ At risk of redundancy, we previously discussed the challenges in achieving #Pharmacoequity, including in the pandemic, noting, “…For example, treatment of patients with #COVID19 has revealed substantial inequities in access to life-saving treatments.”

jamanetwork.com/journals/jama/…
3/ That observation was supported by national CDC data from earlier this year, as well as a recent national analysis of Medicare enrollees that found that Black patients had a 23% ⬇️ odds of receiving monoclonal antibodies when diagnosed with #COVID19.

jamanetwork.com/journals/jama/…
Read 6 tweets
Utibe R. Essien, MD MPH Profile picture
Feb 1, 2022
1/🧵 It’s #BlackHistoryMonth.

A time for us to re-learn and re-discover our history.

A history beyond the chapter on Civil Rightsin our high school textbooks.

A history beyond the Emancipation Proclamation and Brown v. Board of Education.

So what are you reading this month? Image
2/ The ship grew larger & more terrifying w. each stroke of the paddle. The smells grew stronger, the sounds louder, crying & wailing from one quarter, low singing from another; the anarchic noise of children given an underbeat by hands drumming on wood.”

nytimes.com/2022/01/28/opi…
3/ One of the best essays I’ve read.

“Locked out of the greatest opportunity for wealth accumulation in history, African Americans who were able to afford homes found themselves consigned to communities where their investments were affected by the FHA.”

theatlantic.com/magazine/archi…
Read 12 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

Send Email!

:(