The Health Divide: Health equity language disappears, while disparities remain in place

Google has replaced the term “health equity” on its health website, reports STAT.  The company is instead using the term “health optimization.” The company’s former global head of health equity, Dr. Heather Cole-Lewis, also has a new title: global head of health optimization. The move follows President Donald Trump’s ongoing attacks on diversity, equity, and inclusion, or DEI, efforts. Other language on Google’s site has changed, too, from terms like “advancing health equity” to improving “health for everyone, everywhere.”  

It’s part of a broader trend of colleges and universities from Alaska to Arizona backing away from health equity-related language. There’s a widespread retreat in corporate America, too, with companies nationwide removing DEI terms or shifting to terms like “belonging,” according to a recent New York Times analysis.   

At federal government agencies, the anti-DEI efforts haven’t just shifted language — full health equity-related websites are now gone. For example, the FDA’s Office of Minority Health and Health Equitywebsite has been taken down, MedPage Today reported in an article casting doubt on the future of the federal government’s health equity offices.  

As government health data is removed, non-governmental groups and individuals have tried to preserve it by rapidly downloading the data, reports Vox. Groups like KFF saved the entire archive of the Department of Health and Human Services pages while another health analyst said he had gathered health data from the Centers for Disease Control and Prevention. The Association of Health Care Journalists urged journalists to immediately download any data they might need for stories and pitch in on efforts to archive disappearing datasets.  

What happens when there are no doctors or internet? 

It’s called the “the dead zone” — rural areas where 3 million Americans lack both strong internet connections and health care, as KFF Health News outlines in a new investigation by Sarah Jane Tribble and Holly K. Hacker. 

The outlet analyzed and mapped places lacking both internet and health care. Another graphic illustrates the stark health differences such as higher diabetes rates in regions without this dual access.  

In regions with shortages of medical providers, telehealth is often held up as a solution. But that doesn’t work well when health care deserts overlap with internet deserts. “Compared with those in other regions, patients across the rural South, Appalachia, and the remote West are most often unable to make a video call to their doctor or log into their patient portals,” the reporters write.  

The divide has serious health inequity implications. The analysis shows how these gaps are “hitting areas of extreme poverty and high social vulnerability,” Clese Erikson, deputy director of the health workforce research center at the Mullan Institute, told KFF Health News.  

Study shows jump in telehealth use, but disparities remain   

New findings, published in The American Journal of Managed Care, highlighted racial disparities in the use of telehealth for mental health during the pandemic. The data adds to the growing literature highlighting differences in who uses telemedicine, which refers to video calls with providers.  

The latest report looked at racial disparities in tele-mental health use among publicly insured children before and after the onset of the COVID-19 pandemic. Overall, there was a big jump in the share of children with public insurance who used telehealth for mental health care – from about 3% before the pandemic to nearly 36% in 2020.  

But the increase wasn’t shared evenly. Black, Hispanic, Asian and Pacific Islander children experienced smaller increases than their white counterparts. The lowest use came from Asian and Pacific Islander children, whose increase in tele-mental health went up 21% and 25%, compared to a 36% increase among white children.  

In a video on the findings, author Xin Hu said multiple factors likely contributed to the disparities, such as cultural preference for in-person engagement, language barriers, and historic mistrust of the medical system, as well as uneven access to broadband internet.   

The Health Divide previously wrote about another disparity in telehealth, with more telehealth growth coming from higher-earners in cities who have private insurance. 

Living in hotter places linked to accelerated aging? 

A new finding underscores the public health adage that where you live impacts your health. The study, published in Science Advances, found that older adults who lived in high-heat neighborhoods experienced faster biological aging. People throughout the country in these areas of extended extreme heat demonstrated molecular changes that could speed up the aging process. The findings are especially significant when considered amid climate change, which typically has a disproportionate toll on socially vulnerable populations.  

The results connected heat and accelerated aging, but did not necessarily prove that one caused the other. Authors acknowledged that the findings could be influenced by the amount of time someone spends outdoors, or if they had air conditioning, for instance. 

Abortion bans linked to higher infant mortality rates  

Do abortion bans lead to changes in infant mortality rates? New findings, recently published in JAMA, confirmed that states with complete or six-week abortion bans experienced higher rates of infant mortality. These states experienced 6.26 deaths per 1,000 live births, compared to the expected rate of 5.93 without the bans — that’s a 5.6% increase. 

The infant mortality increases were greater among Black infants, as well as those with congenital anomalies, and those born in Southern states – all populations that already experience higher rates. Amid a wave of recent abortion bans, there has been limited evidence on how these changes “may interact with long-standing racial and ethnic disparities in infant health,” the authors wrote.  

Black immigrants less likely to have health care  

Black immigrants may face unique barriers to health insurance coverage, according to findings published in the March edition of Health Affairs. That includes both racism and anti-immigration sentiments they might encounter. The findings are timely, as this group represent a growing portion of the U.S. immigrant populations.  

Black immigrants were 9% more likely to be uninsured than U.S. born white people. That’s the highest among immigrant populations, with one noteworthy exception: Latino immigrants. U.S.-born Latinos have a 31% higher likelihood of lacking coverage, and Latino immigrants have more than double those odds.  

Among all populations, people born in the U.S. and Asian American/Pacific Islander immigrants had the lowest uninsured rates.  

Ending EPA efforts will affect poor, minority communities  

Shuttering the Environmental Protection Agency’s environmental justice offices will impact people who already shoulder health burdens, reports The New York Times. The move will curtail work on curbing pollution for communities near highways or polluting facilities like power plants. This could include efforts such as ensuring safe drinking water. Low-income and minority communities near these pollution sources experience higher rates of asthma and heart disease. 

What we are reading:

• “The office that investigates disparities in veterans’ care is being ‘liquidated,’” by Vernal Coleman, ProPublica
• “5 years since the pandemic started, long COVID patients are still hoping for a cure,” by Will Stone, NPR
• “Dysentery cases on the rise in the Portland area: 40 new cases reported in January alone,” by Mary Walrath-Holdridge, USA Today
• “Federal agency dedicated to mental illness and addiction faces huge cuts,” by Jan Hoffman, The New York Times
• “U.S. is headed toward a hospital bed shortage, researchers warn,” by Erin Blakemore, The Washington Post