Health Disparities A-Go-Go
Canaries in the Coal Mine
MRSA (methicillin-resistant Staphylococcus aureus) has been in the news recently, as people outside the hospital environment (where it is traditionally found) have been diagnosed with the infection. Now, with media headlines such as “New Bacteria Strain Is Striking Gay Men,” a study has been published in the Annals of Internal Medicine reporting a multidrug-resistant strain of MRSA that seems to be disproportionately affecting men who have sex with men (at least in San Fransisco and Boston, where the data was gathered). The study is retrospective (they looked at patients’ charts) and didn’t address specific sexual behaviors (these are limitations), but they observed “high proportion of infection involving the buttocks, genitals, and perineum,” suggesting that the infection may be being spread sexually. Some people (none of my readers, I’m sure) may dismiss this finding as some indictment of gay men. I’d suggest, however, remembering what happened when we thought AIDS would never affect anyone else.
Donor Organs in Short Supply for Rural Residents
A new study published in JAMA looks at people wait-listed for organ transplants, rates of transplant, and survival, comparing urban and rural folks on the list. I haven’t read the whole study yet, but it appears that rural residents waited longer for heart transplants and were significantly less likely to receive a heart transplant than their urban counterparts. Rural residents were also less likely to be added to waiting lists for organs in the first place. Barriers to completing pretransplant evaluations, delayed referrals to specialists, and distance to transplant centers were discussed as possible factors in the disparity. The authors point out in their introduction that “previous research has demonstrated the presence of significant barriers to access to transplantation services for racial minorities, women, and patients with low socioeconomic status or inadequate insurance.”
This headline struck me: “Study probes why U.S. blacks wary of medical trials.” I have a one-word answer for you: Tuskegee. You know, if you systematically withhold treatment from black men with syphilis for about 30 years after penicillin becomes the known, effective treatment, and you don’t really tell they they’re not being treated, it might inspire more than a little distrust in the system. If you add to that all of the headlines we see along the lines of “whites receive better care for x disease” and “we just don’t understand why y is different in the black population,” well, that doesn’t exactly inspire confidence, either.