A roundup of recent Fund publications, charts, multimedia, and other timely content.

The Connection

A roundup of recent Fund publications, charts, multimedia, and other timely content.

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July 10, 2023

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Diversity and Excellence Go Hand in Hand

Amid the outrage and despair over the Supreme Court decision striking down race-conscious admissions in undergraduate education, Commonwealth Fund President Joseph R. Betancourt, M.D., has hope. As a clinician who’s spent a career mentoring students across educational settings, Betancourt has some perspective on the issue. “I interact with students all the time,” he writes on To the Point. He believes the nation’s colleges and universities “won’t turn back the clock.” They understand that “with diversity comes opportunity and excellence, and this doesn’t mean sacrificing merit.”

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Culturally Competent Care Matters for Women of Color

Research shows that Black women and other women of color experience the worst health outcomes of any group in the United States — regardless of income level. On The Dose podcast, host Joel Bervell talks to public health innovator Ashlee Wisdom, who explains that while Black people make up 13 percent of the U.S. population, they are less than 6 percent of physicians, making it difficult for Black patients to connect with Black doctors.

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Getting Women and Families the Support They Need

Even though the U.S. has the highest maternal mortality rate of any developed country, federal programs that have been proven to improve maternal health outcomes are often the target of budget cuts. On The Dose podcast, guest host Rachel Bervell, M.D., speaks with Dr. Jamila Taylor, president and CEO of the National WIC Association, the nonprofit voice of the federal program that provides nutritious foods to more than 6.3 million women, infants, and children. They discuss the potential policy and funding solutions that can advance health for women, especially women of color.

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A Year After Dobbs

Since the U.S. Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization that rescinded the constitutional right to abortion, there has been a wave of state abortion bans and restrictions in states across the country. How are these changes affecting the health of women and their families? A special episode of the Uncared For podcast looks at how Dobbs has not only further limited access to reproductive care in many places but has also struck fear in women and their health care providers — with women of color and women with low income feeling the greatest effects.

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IVF Is Affordable in Belgium. The U.S. Is Another Story.

In vitro fertilization, or IVF, is one of the assisted reproductive technologies turned to most often for the 12 percent of U.S. women who have difficulty getting pregnant. But one round of IVF in the U.S. costs anywhere from $15,000 to $30,000. In International Insights, the Commonwealth Fund’s Evan Gumas writes that Belgium and other high-income countries do a much better job of ensuring affordable access to assisted reproductive technologies such as IVF. Patients undergoing the treatment in Belgium are unlikely to pay more than $550 per cycle under the country’s mandatory public health insurance scheme.

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Expanding a Racial Health Equity Tool Nationally

In 2021, the Illinois Hospital Association launched The Racial Equity in Healthcare Progress Report to providers across the state. More than 140 Illinois hospitals have completed self-assessments so far. Through support from the Commonwealth Fund, Rush University Medical Center is now helping to test and nationally validate this accountability tool, designed to transform data into a roadmap to help organizations identify and eliminate obstacles preventing all patient populations from being healthy.

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The U.S. Has the Greatest Urban–Rural Health Disparities

People living in rural areas of the United States face some of the greatest barriers to accessing care, according to a new analysis involving 11 high-income countries. The study, supported by the Commonwealth Fund and published in JAMA Network Open, used self-reported data from some 22,000 adults to examine disparities in health status and socioeconomic risk, health care affordability, and access to care. The U.S. was found to have significant urban–rural disparities on five health system indicators, while three countries — Canada, Norway, and the Netherlands — had none.

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Better Claims Data Can Lead to Better Medicaid Policies

In 2019, the Centers for Medicare and Medicaid Services released a new generation of Medicaid claims data from all states and territories, aiming to provide researchers with access to the kind of information needed to make sound policy decisions. The data files, however, are expensive to obtain and complex to analyze, say Sarah H. Gordon, K. John McConnell, and William L. Schpero. Based on their work with researchers who use the data, they outline opportunities for improvement: filling gaps in demographic information; ensuring high-quality, unredacted managed care payment data are available; and helping researchers gain easier access to data.

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Learning from COVID-19 to Prepare for the Next Pandemic

The United States can better prepare for future public health emergencies by taking to heart important lessons from the COVID-19 pandemic, say epidemiologists Meagan C. Fitzpatrick and Alison P. Galvani and Commonwealth Fund policy expert Rachel Nuzum on To the Point. To be sure, there have been successes, like the rapid development and distribution of COVID-19 vaccines, which saved more than 3 million U.S. lives and $1 trillion in medical costs. But to prepare for future pandemics, they say the U.S. must strengthen and modernize its public health infrastructure, address socioeconomic and racial disparities, and expand access to health insurance coverage.

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Improving Public Health Data Nationwide

Despite efforts to cobble together substitutes for a nationwide COVID data system, U.S. health authorities were flying blind for much of the pandemic. In a “Perspective” published in the New England Journal of Medicine, former Commonwealth Fund President David Blumenthal, M.D., and Harvard Medical School’s Nicole Lurie, M.D., say pending legislation provides an opportunity to correct this shortcoming.

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Protecting Patients from the Effects of Climate Change

Record-setting heat and poor air quality generated by Canadian wildfires have put residents of a wide swath of the U.S. at risk. Heat-related deaths ([link removed] ) of people in the South, many of them over the age of 60, are rising. A recent issue of Transforming Care describes the steps health care providers are taking to protect vulnerable patients from climate shocks ([link removed] ) .

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