December 1, 2023

This Week

• Top of Mind - The Healthcare System
• And Black America - Diabetes on the Rise
• Reducing the Risk of Stroke - Black People Most Affected
• Eating Red Meat Increases the Risk of Type 2 Diabetes
• Equity, Equality and Justice for All - By William Jahmal Miller
• What to do if you are Getting Ready for Surgery
• COVID Update: Plaxovid to Cost More in 2024
• New AI Took Can Predict Viral Variants, ID Most Dangerous and Help Make Vaccines 'Future-Proof'
• State of Lung Cancer - Racial and Ethnic Disparities

Top of Mind

As a physician, I apologize for whatever part I have played in developing a health care system that is fragmented, disorganized, inconsiderate, rife with unconscious bias against women, people of color and the underserved. You are not getting the health care you need nor deserve. This country is 37th among nations in quality of care and what is worse, no one is talking about changing it.

Regardless of insurance coverage, it may take weeks to see a primary care physician even if you can find one. Often they are no longer with the practice, retired or left medicine altogether to write poetry. And don't try to get an appointment with a specialist. Even for the most acute symptoms they will give you an appointment for several weeks later. As a physician, I used to be able to game the system, if I or my family needed to see another physician but no more. Each plan has a designated panel of doctors, labs or hospitals and I don't know or have never seen the specialist and cannot get past the front desk.

If you are lucky enough to see a specialist in a timely manner, let's not even talk about procedures. Even those that are considered standard of care for evaluating certain conditions become a battle royale between you and the insurance company. They seem to know which older procedures, x-ray or biopsy might not be the latest available but are still useful in some ways. 

Finally pharmaceuticals that are pennies in other countries can be hundreds of dollars here. Sometimes it takes the pharmacy so long to get them your disease may be over by the time they are available to you.

So I submit my apology and commit what energy I have left to making the system better.

Stay Healthy,

Dr. Mike

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This month is Diabetes Awareness Month. According to the Centers for Disease Control and Prevention (CDC), Diabetes affects more than 34 million children, teens, and adults in the United States.  Non-Hispanic African Americans are 60 percent more likely to be diagnosed with Diabetes than non-Hispanic white Americans. In addition to having higher rates of diabetes, Black Americans are also more likely to experience complications from Diabetes. For example, rates of Diabetic Retinopathy are 46 percent higher in African Americans than non-Hispanic whites End stage renal disease due to Diabetes is also 2.6 times more prevalent in Black Americans than non-Hispanic white Americans.

Every 40 seconds, someone in the US has a stroke. Black Americans are disproportionately affected. 80% of strokes are preventable. Reduce the risk of stroke with these 6 steps:

• Monitor blood pressure, sodium, cholesterol, and blood sugar levels
• Stay active and avoid prolonged sitting.
• Embrace the Mediterranean Diet.
• Limit alcohol consumption
• Breathe clean air and avoid pollutants.
• Reduce stressful events if possible; one stressful life event increases stroke likelihood by 17%

Another "steak" through the heart of red meat in the diet. According to researchers at Harvard University, eating just two servings of red meat per week might increase your risk of developing type 2 diabetes later in life. It seems that the more red meat you eat the greater the risk. This study was published this month in the American Journal of Clinical Nutrition.

From the cradle to the grave Black Americans are sicker and die more often than any other ethnic group in America. This difference between the quality of health of Black Americans is measured as a health deficit. Few professionals understand the impact of that deficit like William Jhamal Miller. His book "Equity, Equality and Justice for All" is a must read for anyone interested in solving the barriers to health equity for all Americans.

I have been a fan of Mr. Miller long before his appointment as the first deputy Director for the Office of Health Equity for the state of California in 2013. With a successful background in both public and private healthcare sector administration, he possesses a deep understanding of social dynamics affecting health and the influence of public policy.

This book not only addresses the challenge of health equity in America but also explores how family, faith, tradition, and experience shape the life of a young black American. Mr. Miller emphasizes the importance of seeking advice, learning from mentors, and acknowledging the advocacy of our ancestors. Through research and real-world examples, he shares stories of fighting for justice.

The COVID-19 pandemic has exposed the health disparities affecting Black Americans, and Mr. Miller provides a roadmap to address these challenges. By understanding and confronting inequities, we can work towards equitable health outcomes for all Americans.

This book powerfully reminds us of the interconnectedness of our health. Let us recognize this connection and take action to ensure equitable health outcomes for everyone.

• Attend all appointments and educational seminars as directed by your surgeon.
• Take your medications as directed.
• Quit smoking.
• Eat healthy foods, such as fruits, vegetables, lean meats and whole grains, and drink enough fluids to stay well-hydrated.
• Get plenty of rest.
• Consider a pain management for after the surgery.
• Arrange support from family or friends during and after surgery, including transportation to and from the hospital.
• Most Important - Talk about the surgery with the actual surgeon.

Pfizer will price a five-day course of its COVID antiviral drug Paxlovid at $1,390 when the company starts to transition it to the commercial market later this year.

A company spokesperson on Wednesday confirmed the price, which was first reported by The Wall Street Journal. That list price, which is before rebates and other discounts to insurers and pharmacy benefit managers, is more than double the $529 the federal government paid for Paxlovid.

The government has purchased and distributed Paxlovid to the public for free since December 2021, when the FDA first authorized the treatment. But beginning in 2024, Pfizer will sell Paxlovid directly to health insurers, which comes as demand for COVID vaccines and treatments slumps nationwide.

The COVID-19 pandemic seemed like a never-ending parade of SARS-CoV-2 variants, each equipped with new ways to evade the immune system, leaving the world bracing for what would come next.

But what if there were a way to make predictions about new viral variants before they actually emerge?

A new artificial intelligence tool named EVEscape, developed by researchers at Harvard Medical School and the University of Oxford, can do just that.

In a study published Wednesday in Nature, the researchers show that had it been deployed at the start of the COVID-19 pandemic, EVEscape would have predicted the most frequent mutations and identified the most concerning variants for SARS-CoV-2. The tool also made accurate predictions about other viruses, including HIV and influenza.

The researchers are now using EVEscape to look ahead at SARS-CoV-2 and predict future variants of concern; every two weeks, they release a ranking of new variants. Eventually, this information could help scientists develop more effective vaccines and therapies. The team is also broadening the work to include more viruses. We want to know if we can anticipate the variation in viruses and forecast new variants — because if we can, that’s going to be extremely important for designing vaccines and therapies.

Disparities in diagnosis, treatment, and survival rates between Black and white individuals with lung cancer are stark, revealing a troubling truth that demands our immediate attention.

While the overall rates of lung cancer have seen a decline in the United States over the past few decades, a new concern has emerged. A recent report from the American Cancer Society highlights that women aged 35 to 54 are being diagnosed with lung cancer at higher rates than their male counterparts in the same age group. Although the difference may seem small, with just one or two more cases per 100,000 women, it signifies a larger issue at hand. This revelation underscores the pressing need for equitable healthcare access and personalized solutions in our ongoing fight against lung cancer.

Lung cancer remains the leading cause of cancer-related deaths in the United States, with approximately 197,000 people diagnosed annually. The disparities in the rates of diagnosis among women in the specified age range compared to men are significant enough to warrant further investigation.

As we grapple with these complexities, it is crucial to note that there is no clear-cut explanation for the observed disparities so intensified research and future studies is needed to unravel the factors contributing to these differences.

The fight against lung cancer requires a united effort to break down barriers, address disparities, and strive for a future where every individual receives the care they deserve.

For more information, go to our website at www.aawellnessproject.org. or listen to our podcast at Blackdoctorsspeak.org on any podcast platform.

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DR. MIKE'S ETHNIC HEALTH REPORT