Journal of women's health
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Journal of women's health · Sep 2022
ReviewBreast Cancer in Black Women: Racial/Ethnic Disparities Affecting Survival.
Breast cancer is the most common noncutaneous malignancy affecting women in the United States, with >245,000 cases diagnosed annually. Breast cancer mortality rates have continued to trend down in the past three decades, yet racial/ethnic disparities persist, with the worst mortality rates seen in Black women. Of note, when compared by race, this downward trend is also trailing in Black women. ⋯ Facing the worst poverty rates compared with other races, Black women are inevitably more likely to be uninsured, have limited access to quality education, and have fewer financial resources. The goal of this review was to elucidate the complex interplay between biological and social factors contributing to racial disparities in breast cancer outcomes. We conclude by emphasizing the need for interventions made at both local and national levels.
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Journal of women's health · Sep 2022
Postpartum Hospital Readmissions and Emergency Department Visits Among High-Risk, Medicaid-Insured Women in New York City.
Objectives: To describe the incidence of and characteristics associated with postpartum emergency department (ED) visits and hospital readmissions among high-risk, low-income, predominantly Black and Latina women in New York City (NYC). Methods: We conducted a secondary analysis of detailed survey and medical chart data from an intervention to improve timely postpartum visits among Medicaid-insured, high-risk women in NYC from 2015 to 2016. Among 380 women who completed surveys at baseline (bedside postpartum) and 3 weeks after delivery, we examined the incidence of having an ED visit or readmission within 3 weeks postpartum. ⋯ The odds of seeking postpartum hospital care remained roughly 2.5 times higher among women with hypertension or depression/anxiety in adjusted analyses. Conclusions: We identified characteristics associated with ED visits and hospital readmissions among a high-risk subset of postpartum women in NYC. These characteristics, including depressive symptoms and hypertension, suggest women who may benefit from additional postpartum support to prevent maternal complications and reduce health disparities.
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Journal of women's health · Sep 2022
Addressing Racial Disparities in Pregnancy-Related Deaths: An Analysis of Maternal Mortality-Related Federal Legislation, 2017-2021.
There has been increasing national attention to the issue of racial disparities in pregnancy-related deaths. Federal legislation can support approaches at multiple levels of intervention to improve maternal health. As part of the CDC Policy Academy, a team of CDC staff completed a policy analysis to determine the approaches addressed in federal legislation to reduce racial disparities in pregnancy-related deaths. ⋯ The most common themes mentioned in federal legislation were improving maternal health care, addressing health inequities and SDOH, enhancing data, and promoting women's health. Legislation focused on health inequities and SDOH emphasized implicit bias training and improving SDOH, including racism and other social factors. The reviewed federal legislation reflected common clinical and public health approaches to prevent pregnancy-related deaths, including a significant focus on reducing bias and improving SDOH to address racial disparities.
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Background: Female physicians have a higher prevalence of infertility compared with the general population. Physician well-being can be significantly impacted by the physical and emotional challenges associated with this, including the high cost of fertility treatments, which are often not covered by health insurance. There are limited data on the current state of fertility coverage available for physicians. ⋯ Conclusion: There is wide variation in fertility benefits offered at top medical schools across the country. Many schools offered coverage for fertility evaluation and treatments; however, majority had restrictions and limitations to the benefits, suggesting that there is still inadequate coverage provided. This study's selected sample also does not reflect other medical schools across the country, which may not be as well-resourced in their provision of fertility benefits.
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Journal of women's health · Sep 2022
Why Patients Fall Through the Cracks: Assessment of Patients' Overactive Bladder Treatment.
Objective: Despite an established treatment algorithm for overactive bladder (OAB), it is unclear how many patients proceed through each step. Our objective was to evaluate the percentage of patients receiving each step of care and identify reasons why patients did not receive certain treatments. Methods: This was a retrospective cohort study with cross-sectional survey of new OAB patients. ⋯ Conclusions: Many patients do not progress to the next steps in OAB therapy despite failure of more conservative treatments. Barriers to care included limited follow-up and education about other therapy options. A formalized institutional care pathway may lead to improved OAB treatment.