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Good morning! The First Opinion Podcast is back today. We’ll have episodes in your feed every Wednesday morning for the rest of the year. The first five episodes are specifically focused on issues relevant to the election. This week: How the 2024 election gets mental health right — and wrong.
Women with sickle cell are sterilized postpartum more than others, data shows
Earlier this year, STAT’s Eric Boodman reported the heartbreaking story of how, for decades, doctors have pressured sickle cell patients into getting unwanted sterilizations. In Part 4 of his Coercive Care series, new data analysis shows that these may not be isolated incidents or a simple problem of a few bad doctors.
Between 2012 and 2019, 8.8% of deliveries to people with the disease ended in a tubal sterilization, compared to just 6.7% of births to other mothers, researchers found. Among sickle cell patients with severe pregnancy complications, 16.7% got postpartum sterilizations; among those without the disease who experienced such complications, 8.6% got those surgeries.
Sickle cell is “a perfect storm of confounding factors,” as Eric puts it. Most people who have it are Black, two-thirds are on government insurance, and more than half live in the South. These are all predictors of sterilization, meaning it can be hard even for experts to understand if there’s a specific phenomenon going on with sickle cell patients.
“I had no idea what these researchers would find when they analyzed these data,” Eric told me. Read more about the analysis, which is based on data from 30 million deliveries, making it the most comprehensive contemporary examination of sterilization rates in the American sickle cell community. And don’t miss his earlier stories on doctors steering patients into unwanted sterilizations, on one woman pressured keep a pregnancy in order to be treated for pain, and on a federal rule that has unintentionally made it harder for patients to get contraception.
During VP debate, health care statements dissected on stage — and online
Vice presidential candidates Sen. JD Vance and Gov. Tim Walz dove deep into health insurance policy last night during their debate. Vance initially sidestepped a question about comments he made last month that insurers should be allowed to cover sick people separately from healthier people, attracting attacks from Democrats. But then he described his previous statement as being about reinsurance and letting states experiment with the way they cover residents with chronic illness. Walz said that Vance’s plan would let insurers attract healthy people into plans while pricing out sick people.
There was also movement outside the arena, as former President Donald Trump sought to further soften his abortion position on social media.
“EVERYONE KNOWS I WOULD NOT SUPPORT A FEDERAL ABORTION BAN, UNDER ANY CIRCUMSTANCES, AND WOULD, IN FACT, VETO IT, BECAUSE IT IS UP TO THE STATES TO DECIDE.” Trump announced on X, after previously refusing to say if he would do so during his debate with Vice President Kamala Harris.
Read more from STAT’s John Wilkerson on how the night shook out.
A new crop of ‘geniuses’
The 24 fellows announced by the MacArthur Foundation yesterday include a master hula dancer, a pianist, a poet — and people with a wide range of expertise in the worlds of science and health.
Here are a few that caught my eye:
- Martha Muñoz researches the factors that influence evolution, both in nature and in the lab. Her research on how tropical and mountain lizards both adapt to endure their habitats has shown that evolution isn’t all about natural selection, but rather organisms actually have some agency in the process.
- Alice Wong is a writer, editor, and disability activist. “I address the lack of disabled voices in publishing, journalism, and popular culture, and illustrate the systemic ableism that renders disabled people as disposable burdens and objects of pity,” she said in a MacArthur Foundation video.
- Ruha Benjamin researches and writes about how innovation isn’t simply synonymous with progress — it can often lead to inequity. For example, there’s what she calls “the New Jim Code,” like algorithms that promote real estate based on “ethnic” preferences that contribute to segregation or crime prediction software that leads to intense surveillance in Black or brown neighborhoods. (Benjamin was also named to the STATUS List earlier this year.)
Read more from the MacArthur Foundation about the other fellows. And maybe take a look at our whole STATUS list again — you never know who might be a “genius” in the making!
What we can learn from the dogs of Chernobyl
Thirty-eight years after the Chernobyl nuclear disaster, the 1,000 square mile area is like a set-piece from “The Last of Us.” The irradiated land is mostly devoid of humans, but crowded with birds, rodents, foxes, bears, bison, deer, moose, wild horses, and, as you may have heard: Dogs. Scientists have studied some smaller creatures there before, but last year, researchers told STAT’s Jason Mast about the potential benefits of studying the zone’s best boys.
These dogs make particularly good research subjects, and understanding how they’ve adapted to radiation could someday help to protect humans who work at power plants or (more enticingly) who are heading into space on a Mars mission.
But while that work continues, life is getting harder for the dogs. They used to rely on workers coming into the area for food and shelter, but as the war in Ukraine wages on, personnel and resources are low. To protect the dogs, the Clean Futures Fund, a nonprofit involved in the research, collaborated with animal care product company Farm & Yard to place 20 insulated dog houses around the area. (In the photo above, you can see one local stray considering the home.)
Read Jason’s story to learn more about what these dogs can teach us about life at the edge.
1 in 14
That’s how many hospital patients who receive general medical care may experience harmful diagnostic errors, according to a study published yesterday in BMJ Quality & Safety.
Researchers reviewed electronic health records from 675 patients at one hospital and retrospectively estimated the prevalence of harmful errors. They did this by having two adjudicators assess the risk for error and patient outcomes in each individual case. Since the study is based on just one location, it’s hard to extrapolate too much from the data. Still, the authors write that the results highlight the need for better approaches to surveillance of adverse events.
Racial disparities in cancers & some quick breast cancer facts
Black Americans have higher mortality rates from all types of cancers. There’s also evidence that this group gets more cancers that involve extra copies of genes, which can make the disease more aggressive. A new paper found that these genetic duplications aren’t linked to African American ancestry, but may be related to exposure to environmental pollutants. STAT’s Anil Oza has more on that research.
A report from the American Cancer Society, released yesterday, offers further insights into racial disparities in breast cancer. Black women have a 38% higher death rate from breast cancer compared to white women, despite having a 5% lower incidence rate. And at every single stage of breast cancer, Black women have the lowest survival rate.
A few more statistics from the report:
- About one in eight U.S. women will be diagnosed with invasive breast cancer in their lifetime, and one in 43 will die from it.
- Breast cancer mortality has declined since 1990 across all racial and ethnic groups — except for American Indian/Alaska Native women. That group’s rates have remained steady.
- Among men, Black men have the highest incidence and mortality rates of breast cancer.
What we’re reading
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California sues hospital for denying patient an emergency abortion, New York Times
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Tim Walz’s state became a ‘trans refuge.’ Here’s what that means and how it happened, NPR
- When should marijuana use deny a patient an organ transplant? STAT
- Hurricane sends new shudders through health supply chain, Axios
- Key lawmakers pressure Biden to preserve telehealth prescribing of effective addiction treatment, STAT
