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Utibe R. Essien, MD MPH Profile picture
Utibe R. Essien, MD MPH
@UREssien
Physician Scientist | Assistant Professor @UCLA | Alum @HarvardChanSPH @MGHMedicine @EinsteinMed | Opinions mine | #Pharmacoequity 💊
Apr 17, 2023 • 12 tweets • 14 min read
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
Sep 8, 2022 • 5 tweets • 11 min read
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
Sep 7, 2022 • 8 tweets • 9 min read
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
Jul 27, 2022 • 12 tweets • 12 min read
‼️ 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/
Jul 25, 2022 • 6 tweets • 5 min read
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
Feb 10, 2022 • 6 tweets • 6 min read
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/…
Feb 1, 2022 • 12 tweets • 8 min read
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…
Dec 1, 2021 • 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…
Oct 22, 2021 • 10 tweets • 9 min read
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/…
Jun 3, 2021 • 11 tweets • 8 min read
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
Jun 2, 2021 • 4 tweets • 3 min read
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.
Jun 1, 2021 • 5 tweets • 2 min read
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
May 17, 2021 • 11 tweets • 5 min read
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/…
Oct 19, 2020 • 7 tweets • 3 min read
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/
May 17, 2020 • 5 tweets • 3 min read
🚨New Paper (Pre-Print)🚨

As many have noted, one of the keys to addressing the racial disparities in #COVID19 is ensuring comprehensive race/ethnicity data. Yet, as late as mid-April, 22 states were still not reporting such data on mortality. Here's what else we found...

1/ As of April 21st, of the 28 states reporting race/ethnicity data related to #COVID19 mortality, we found significant variation in the quality of such reporting, with some states reporting as high as >40% missingness in these data.

2/
Apr 28, 2020 • 8 tweets • 9 min read
The health inequities observed in the #COVID19 pandemic have been devastatingly alarming.

Grateful my friend and one of the smartest people I know, ⁦@atheendar⁩ joined me to share some solutions to address this problem in ⁦@JAMAHealthForum⁩. jamanetwork.com/channels/healt… "Now, emerging data illustrate that Black and Hispanic Americans are dying at far higher rates from Covid-19 than any other groups in the nation. These disparities are just the most recent manifestation of centuries’ worth of racial and ethnic gaps in health outcomes." 2/
Apr 3, 2020 • 35 tweets • 19 min read
Before the grants are reviewed, the IRBs are submitted, the data are analyzed, and the manuscripts are in press, reporters will likely continue to shed light on the issues related to #COVID19 and #HealthEquity.

A thread of articles, to be daily updated, on this topic. 1/ "Public health experts caution that the nature of this virus means that inequality in health outcomes puts the entire population at risk. Pockets of people who are untested or don't get the appropriate medical treatment can quickly become new clusters." 2/
nytimes.com/interactive/20…
Jan 22, 2020 • 6 tweets • 8 min read
Thrilled to share my first VA paper (and first visual abstract!) with my all-star @vaequity @PittGIM mentor team, on racial and ethnic differences in the medical treatment of opioid use disorder within the VA following a non-fatal opioid overdose. 1/n

link.springer.com/article/10.100… @vaequity @PittGIM Prior studies (@LarochelleMarc et al.) showed that opioid prescribing and the use of medications for opioid use disorder (MOUDs) remains low, even after a non-fatal overdose. Further, a recent paper by @PoojaLagisetty showed racial disparities in MOUD. 2/n
jamanetwork.com/journals/jamap…
Aug 20, 2019 • 5 tweets • 5 min read
In case you missed it, @iamjohnoliver hosted an episode Sunday night on gender and racial bias in medicine. Here are a few of the studies on racial disparities he highlighted on the episode. 1/ @iamjohnoliver In a study of patients admitted to trauma centers in PA, authors found that patients admitted to hospitals with high concentrations of blacks had a 43% higher odds of death compared with patients admitted to hospitals treating low proportions of blacks. 2/
onlinelibrary.wiley.com/doi/full/10.11…