Sterilizations of sickle cell patients, differences in cancer

Get your daily dose of health and medicine every weekday with STAT’s free Morning Rounds newsletter. Sign up here.

Good morning! The First Opion Podcast returns today. We’ll have episodes in your feed every Wednesday morning for the rest of the year. The first five episodes focus specifically on issues relevant to the election. This week: how the 2024 election makes mental health care right and wrong.

Data shows that women with sickle cell disease are sterilized postpartum more often than others

Earlier this year, STAT’s Eric Boodman reported the heartbreaking story of how doctors for decades pressured sickle cell patients to undergo unwanted sterilizations. In part 4 of his Coercive Care series, new data analysis shows that these may not be isolated incidents or a simple problem of a few bad doctors.

Between 2012 and 2019, 8.8% of births to people with the disease ended in tubal sterilization, compared to just 6.7% of births to other mothers, researchers found. Of the sickle cell patients with serious pregnancy complications, 16.7% underwent postpartum sterilizations; of those without the disease who experienced such complications, 8.6% underwent these surgeries.

Sickle cell disease is “a perfect storm of confounding factors,” as Eric puts it. Most of the people who have it are black, two-thirds have government insurance and more than half live in the South. These are all predictors of sterilization, meaning it can be difficult even for experts to understand whether there is a specific phenomenon going on in sickle cell patients.

“I had no idea what these researchers would discover when they analyzed this data,” Eric told me. Learn more about the analysis, which is based on data from 30 million deliveries, making it the most comprehensive contemporary study of sterilization rates in the U.S. sickle cell community. And don’t miss his previous stories about doctors pushing patients into unwanted sterilizations, about a woman pressured into getting pregnant to be treated for pain, and about a federal rule that has inadvertently made it harder for patients to get birth control. to get.

During the VP debate, healthcare explanations were dissected on stage – and online

Vice presidential candidates Senator JD Vance and Governor Tim Walz delved deep into health insurance policies during their debate last night. Vance initially sidestepped a question about comments he made last month that insurers should be able to cover sick people separately from healthier people, drawing attacks from Democrats. But he then described his earlier statement as being about reinsurance and letting states experiment with how they cover residents with chronic illnesses. Walz said Vance’s plan would allow insurers to include healthy people in plans while pricing out sick people.

There was also movement outside the arena, as former President Donald Trump tried to further soften his stance on abortion on social media.

“Everyone knows that under no circumstances would I support a federal abortion ban, and in fact would veto it, because it is up to the states to decide.” Trump announced this on X, after previously refusing to say whether he would do so during his debate with Vice President Kamala Harris.

Read more from STAT’s John Wilkerson on how the night shook.

A new class of ‘geniuses’

The 24 fellows announced yesterday by the MacArthur Foundation include a master hula dancer, a pianist, a poet – and people with a wide range of expertise in the worlds of science and health.

Here are a few that caught my attention:

• Martha Munoz examines the factors that influence evolution, both in nature and in the laboratory. Her research into how both tropical and mountain lizards adapt to their habitats has shown that evolution is not just about natural selection, but that organisms actually have some influence.

• Alice Wong is a writer, editor and disability activist. “I discuss the lack of disabled voices in publishing, journalism, and popular culture, and illustrate the systemic ableism that makes people with disabilities disposable burdens and objects of pity,” she said in a MacArthur Foundation video .

• Ruha Benjamin researches and writes about how innovation is not simply synonymous with progress – it can often lead to inequality. For example, there is what she calls “the New Jim Code,” such as algorithms that promote real estate based on “ethnic” preferences and contribute to segregation or crime prediction software that leads to intense surveillance in black or brown neighborhoods. (Benjamin was also named to the STATUS list earlier this year.)

Read more from the MacArthur Foundation about the other fellows. And maybe check out our entire STATUS list again – you never know who might be a “genius” in the making!

What we can learn from the dogs of Chernobyl

Thirty-eight years after the Chernobyl nuclear disaster, the 1,000 square kilometer area looks like a set piece from ‘The last of us.” The irradiated land is largely devoid of people, but full of birds, rodents, foxes, bears, bison, deer, elk, wild horses and, as you may have heard: dogs. Scientists have studied some smaller creatures there before, but last year researchers told STAT’s Jason Mast about the potential benefits of studying the zone’s top guys.

These dogs make particularly good research subjects, and understanding how they have adapted to radiation could one day help protect people working in power plants or (more enticingly) heading to space on a Mars mission.

But as that work continues, life becomes increasingly difficult for the dogs. They used to rely on workers coming to the area for food and shelter, but as the war in Ukraine continues, staff and resources are scarce. To protect the dogs, the Clean Futures Fund, a nonprofit involved in the research, worked with the pet care product company Farm & Yard to install 20 insulated dog houses in the area. (In the photo above you can see a local stray dog ​​looking at the house.)

Read Jason’s story to learn more about what these dogs can teach us about life on the edge.

1 in 14

That’s how many hospital patients receiving general medical care may experience harmful diagnostic errors, according to a study published yesterday BMJ quality and safety.

Researchers reviewed the electronic medical records of 675 patients at one hospital and retrospectively estimated the prevalence of harmful errors. They did this by having two judges assess the risk of error and patient outcomes in each individual case. Because the study is based on just one location, it is difficult to extrapolate too much from the data. Still, the authors write that the results highlight the need for a better approach to side effect surveillance.

Racial differences in cancers and some quick facts about breast cancer

Black Americans have higher death rates from all types of cancer. There is also evidence that this group develops more cancers that involve extra copies of genes, which can make the disease more aggressive. A new paper finds that these genetic duplications are not linked to African American ancestry, but may be linked to exposure to environmental pollutants. STAT’s Anil Oza has more on that research.

A report from the American Cancer Societyreleased yesterday provides further insights into racial disparities in breast cancer. Black women have a 38% higher mortality rate from breast cancer compared to white women, despite a 5% lower incidence. And at every stage of breast cancer, black women have the lowest survival rate.

Some more statistics from the report:

• About one in eight American women will be diagnosed with invasive breast cancer in their lifetime, and one in 43 will die from it.
• Breast cancer mortality has declined since 1990 among all racial and ethnic groups except American Indian/Alaska Native women. The rates for that group have remained stable.
• Among men, black men have the highest incidence and mortality rates of breast cancer.

What we read

• California sues hospital for denying emergency abortion to patient New York Times

• Tim Walz’s state became a “trans-sanctuary.” Here’s what that means and how it happened: NPR

• When should marijuana use deny a patient an organ transplant? STAT
• Hurricane sends new shivers through the healthcare chain Axios
• Key lawmakers are pressuring Biden to keep prescribing effective addiction treatment through telehealth, STAT