Black maternal mortality in the media: How journalists cover a deadly racial disparity

Through semi-structured interviews with four women news journalists, this study explores how journalists who specialize in women’s issues and health cover Black maternal mortality. Discussions include the role of advocacy in journalism and the struggle of covering the complex, long-standing systemic issue of maternal mortality associated with race in American society. Six themes consider the inclusion of race in healthcare coverage, a need for in-depth, nuanced coverage, the role of advocacy in journalism, complications of reporting on race, the importance of citing sources of color, and celebrity influence. Findings show the need for media advocacy in public health crises, and how journalistic norms can pressure journalists into citing inappropriate sources or diluting the story.

Racial Disparity in the Surgical Management of Diverticular Disease

Introduction Although minimally invasive surgery (MIS) has clearly been associated with improved colorectal surgery outcomes, not all populations benefit from this approach. Using a national database, we analyzed both, the trend in the utilization of MIS for diverticulitis and differences in utilization by race. Methods Colon-targeted participant user files (PUFs) from 2012 to 18 were linked to respective PUFs in National Surgical Quality Improvement Project. Patients undergoing colectomy for acute diverticulitis or chronic diverticular disease were included. Surgical approach was stratified by race and year. To adjust for confounding and estimate the association of covariates with approach, data were fit using multivariable binary logistic regression main effects model. Using a joint effects model, we evaluated whether the odds of a particular approach over time was differentially affected by race. Results Of the 46 713 patients meeting inclusion criteria, 83% were white, with 7% black and 10% other. Over the study period, there was a decrease in the rate of open colectomy of about 5% P < .001, and increase in the rate of utilization of laparoscopic and robotic approaches (RC) P < .0001. After adjusting for confounders, black race was associated with open surgery P < .0001. Conclusion There is disparity in the utilization of MIS for diverticulitis. Further research into the reasons for this disparity is critical to ensure known benefits of MIC are realized across all races.

Centering Racial and Ethnic Equity in Health Care Throughout Spatial Data Analysis

BackgroundThe ongoing COVID-19 pandemic as well as a host of social movements have put a nation-sized spotlight on structural inequality and racial disparities in health throughout America. As health care systems begin to advance health equity by holding plans and payers accounting for racial and socioeconomic disparities in care, quantitative methods are needed that emphasize the distinct linkages between physical locations and racially disparate outcomes.MethodsWe apply a counterfactual model to compare differences in avoidable and potentially avoidable emergency department (ED) admissions among a panel of 8,924 non-Hispanic White, Black, and Hispanic Medicaid participants between 2016 - 2018. The magnitude of disparity estimates is examined in relation to geographic proximity to health care providers, neighborhood socioeconomic contexts, as well as the type of primary care delivery model individuals received. The adjusted rates were assessed by generalized estimating equations (GEE) and average marginal effects models to contrast differences in probability of events in association with race/ethnicity, proximity to care, and treatment through patient-centered medical homes (PCMH). ResultsAttending a patient-centered medical home was associated with a 3.4 percentage point (p <0.001) decrease in Black-White racial disparity and a 1.8 percentage point (p < 0.10) reduction in the overall Black-White disparity for potentially avoidable ED admissions. PCMH attendance was attributed to a 2.6 percentage point (p < 0.10) reduction in Hispanic-White disparities in potentially avoidable admissions, but this difference was not substantial enough to curb the overall Hispanic-White racial disparity in ED admissions. No statistically significant reductions in Black-White or Hispanic-White disparities in avoidable ED admissions were observed. ConclusionMedical homes may be able to curb, but not necessarily eliminate, racial disparities in ED admissions. Counterfactual models of health disparities are in line with recent transitions toward evaluating patient- and value-centered health care reform changes as they are designed to measure health and racial equity. This strategy, or variations of it, are adaptable to other investigations where emphasis on physical locations is considered essential to understanding racial disparities in health outcomes.