THE LASTING EFFECTS OF INTIMATE PARTNER VIOLENCE
Intimate partner violence (IPV)—physical, sexual, or psychological aggression—has a lasting impact on affected women. Women who have lived in a violent relationship have higher rates of bodily pain, depression, suicide attempts, and PTSD compared to women who have not, and these health effects of violence against women often persist for decades.
READING, WRITING, AND VACCINATION
Maine, 2009: a flu pandemic is underway. State and education authorities decide to have all K-12 schools in the state offer vaccination clinics. The resulting 25% increase in vaccinations of Maine children was extrapolated by the authors to determine the effectiveness of this policy in preventing flu-related illness across Maine’s population. The conclusion: school-based flu shot clinics can be a cost-effective way of vaccinating children who are typically under-immunized. If vaccine supplies are limited, however, such clinics reduce availability for adults, and may put the elderly at risk. The allocation of vaccine during a mass immunization depends on decisions regarding targeted age groups, infection risks, and potential venues for delivering protection rapidly.
WHEN DOCTORS RESPOND TO GUIDELINES
In 2009, the American College of Obstetricians and Gynecologists suggested that cervical cancer screening for women before the age of 21 was no longer required. This study of 18 to 20-year-old women in the Tennessee Medicaid program showed a 73% decline in Pap tests over the next five years in response to guidelines, and a parallel decrease in the frequency of unnecessary and potentially harmful colposcopies and invasive cervical procedures. Costs also fell more than $100 per woman. HPV vaccine remains the preferred way to prevent cervical cancer. Young women who no longer receive a Pap test for cervical cancer may still need testing for other STDs such as chlamydia, and should be vaccinated against HPV if they weren’t as adolescents.
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RACIAL EQUITY IN TRANSPLANTS
Stark disparities exist between the health outcomes of white people and minorities across a wide range of health indicators. One prime example is organ transplant allocation. Prior to 2015, kidney transplants for those with end-stage renal disease went to white patients at a much higher rate. A new allocation system was devised in order to change that. The simple yet ingenious solution attacked the structural cause for the inequity. It kept time on the donation list as the main selection criteria, but the fix by the United Network for Organ Sharing (UNOS) acknowledged that because of underlying healthcare disparities, black and Hispanic people spend more time on dialysis before being put on the list. The new system places the starting point at the earliest date a patient was either put on the list or started regular dialysis treatments. Melanson et al. show in their Health Affairs article that the new UNOS system worked as intended and that the disparities have been largely addressed.
"New Kidney Allocation System Associated With Increased Rates Of Transplants Among Black And Hispanic Patients." Taylor Melanson et al. HEALTH AFFAIRS VOL. 36, NO. 6: PURSUING HEALTH EQUITY. https://doi.org/10.1377/hlthaff.2016.1625
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