J Natl Med Assoc
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Socioeconomic inequities have direct implications in COVID presentation, severity of illness and prognosis. From practice of prophylactic measures to availability of personal protective equipment, from access to diagnostic tests to treatment resources, there are many facets and distinct disease processes of a virus that, among many things, serves to expose and highlight our global disparities.
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Transparency about the costs that patients incur is an increasingly important factor in making decisions throughout the course of diagnosis and treatment. Both patients and providers regard honest, informed discussions about these costs as critical to providing person-centered care, but often encounter a range of barriers to initiating and maintaining these conversations. ⋯ These include components of financial toxicity for patients, both related to direct costs and to quality of life, as well as questions as to who should initiate these conversations, when they should take place, and what kind of information and training are needed to make these conversations meaningful. This article reports the results of this work with recommendations for providers about how to incorporate cost of care discussions into the normal clinical work flow and patient life flow.
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Health Disparities and Constipation Management among Pediatric Patients in the Emergency Department.
Constipation is a common cause of abdominal pain in children. Prior studies have demonstrated that nearly half of the children with constipation receive enemas; however, studies regarding constipation management based on race and ethnicity have not been pursued. The goal of this investigation is to determine if demographic disparities namely, race and ethnicity and insurance status affect emergency department (ED) management of constipation and prescription of enema. ⋯ Racial and health disparities do not appear to impact a physician's decision on giving an enema to children with constipation presenting to the ED.
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Black women in Minnesota and beyond have a greater burden of death due to some cancers than their White counterparts. Delayed screening and treatment may explain these disparate statistics. The purpose of this study was to work in collaboration with a local Black faith-based organization to gain an updated understanding of Black women's knowledge, attitudes, and behaviors related to breast and cervical cancer, and determine to what extent known factors persist as barriers to accessing cancer screening among Black women in Rochester, MN. We also sought to identify unique barriers for Black women residing in a particularly health resource rich community. ⋯ Black women face real and perceived barriers to cancer screening even where health resources are abundant. Results reiterate an on going need for culturally appropriate interventions to improve Black women's breast and cervical cancer screening participation by minimizing barriers and engaging entire communities - including Black women, religious leaders, and health care providers.