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September 27th, 2021

Podcast 279: Age-specific data do better than age-adjusted data in revealing health inequities

Kiarri Kershaw has written a simple letter in JACC — the Journal of the American College of Cardiology. The letter conveys a strong message: health inequities don’t act uniformly across one’s lifetime. Her examination of Black versus white mortality from all causes and from cardiovascular causes with the use of age-specific data shows places in the life of a population where health interventions could lower mortality risks. Using age-adjusted data to examine an entire population is too coarse an approach.

She and her colleagues found that older Black people (age 85+) show a survival advantage over whites, despite the fact that whites hold the advantage at every other age interval. There are several possible reasons for this, and Dr. Kershaw and my co-host Dr. Karol Watson offer a few.

This is probably the shortest Clinical Conversation ever, coming in at under 7 minutes. And it’s well worth your listening time.

Dr. Kershaw’s letter in JACC.

April 27th, 2021

Podcast 278: Where equity and community health intersect — a conversation with Joseph Betancourt

An internist at Massachusetts General Hospital, Dr. Joseph Betancourt also runs their program on equity and community health.

In this, the final entry in our four-interview exploration of race and clinical equity, Betancourt talks about the need for medical institutions to pay attention to what’s happening in their patients’ communities. To that end, MGH has a “bodega makeover” initiative to bring healthy food choices to local stores. (His grandfather’s bodega in Spanish Harlem likely served as an inspiration.)

Running time: 17 minutes

April 26th, 2021

Podcast 277: Race and clinical equity — know your patients — a conversation with Karen Dorsey Sheares

Dr. Sheares talks about her experience with inequities. She believes that clinicians should aspire to be students of their patients as well as of the pathophysiology of the diseases their patients present with.

Listen in.

Running time: 20 minutes

April 18th, 2021

Podcast 276: Pay attention to the structural barriers that contribute to clinical inequity — Karol Watson

In this, our second conversation on race and clinical equity, Dr. Karol Watson of UCLA offers her observations on what she’s observed as a cardiologist trying to deal with treatment plans for patients who’ve lost their health insurance or have had to go to a plan that doesn’t cover what’s needed.

She reminds us that tagging people as “non-compliant” would often be better expressed as “unable to afford.”

Let me know what you think, please, at jelia@nejm.org

Running time: 10 minutes

April 11th, 2021

Podcast 275: Race and Clinical Equity — a Conversation with Dr. Kimberly Manning

We’ve conducted a set of four interviews with physicians on the topic of race and clinical equity.

The conversations center not so much on their published research, but on the roles that these physicians take in their organizations and, in addition, the stories they tell about their own experiences.

Our first is with Dr. Kimberly Manning, who’s a professor of medicine at Emory.

Let us know what you think. Write to me at jelia@nejm.org.

Running time: 20 minutes

January 18th, 2021

Podcast 274: Preliminary Thoughts on the 2021 ASCO Gastrointestinal Cancer Conference

Apologies for the long silence. We have been off doing other things — one of which has been figuring out how to cover conferences. Last month, after much preparation, we covered the American Society of Hematology (ASH) annual conference; our second foray consists of brief coverage of the American Society of Clinical Oncology (ASCO) gastrointestinal cancer symposium.

We present a brief, pre-conference chat in this edition. It was conducted just before the ASCO conference began, to get a sense of our guides’ expectations. Those guides — David Ilson, Ghassan Abou=Alfa, and Axel Grothey — are interviewed here and will be interviewed again at the end of the conference. The are expert, respectively, in cancers of the esophagus; stomach, liver, and pancreas; and the colon and rectum.

In forthcoming interviews, I will share several of the interviews done with hematologists for ASH. I hope you will find them as fascinating as I have.

Running time: 19 minutes

Clinical Conversations

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