SEARCH · PubMed Health

Results for “Healthcare Disparities”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

PubMed2025

Leveraging Pharmacy Education through a Train-the-Trainer Model to Enhance Breast Cancer Literacy in Rural Communities.

Rural versus urban communities experience disproportionate challenges in breast cancer outcomes, with higher breast cancer mortality and later stage disease presentation, despite similar diagnosis rates. These disparities are driven by structural barriers, including rural hospital closures, transportation difficulties, and limited access to oncology specialists. This study evaluated a train-the-trainer program designed to equip PharmD students located at a pharmacy school in a rural county in South Carolina with breast cancer education training, leveraging the pharmacists' position as accessible healthcare professionals in rural communities. Training focused on breast cancer risk factors, prevention, screening, genetics, staging, and treatment options. Effectiveness was measured through pre- and post-workshop confidence surveys and knowledge assessments. Results showed significant improvement in student confidence across educational domains, with average scores increasing from 6.30 to 8.59 (p < 0.0001). Understanding of screening guidelines (mean difference: 4.30; p-value: < .0001) and target therapy options showed the greatest improvement (mean difference: 3.65; p-value: < .0001), while knowledge of BRCA gene inheritance showed the smallest change (mean difference: 0.369; p-value: ns), suggesting some pre-existing awareness but limited understanding of its clinical applications. Overall, this pilot program demonstrates how pharmacy education can address healthcare disparities in rural communities. By preparing pharmacists to deliver accurate breast cancer education and to increase rural patient agency, this model creates a sustainable approach to improving health literacy in medically underserved areas. Future research could further expand this model to include diverse healthcare professionals and incorporate long-term impact assessments in community settings.

Humans↗

PubMed2026

Availability and public reimbursement of early breast cancer care across European expert centres: a PORTRAIT from an EUSOMA initiative.

BACKGROUND: Cross-country disparities in access to guideline-recommended early breast cancer care persist across Europe. PORTRAIT is a clinician-reported, cross-sectional access study mapping availability and state reimbursement of key services across the early breast cancer pathway. METHODS: A 49-item survey covering diagnostics, pathology and genomics, systemic therapy, surgery, radiotherapy, and supportive care was emailed from June to September 2024 to multidisciplinary teams at one expert breast centre in 42 European countries. Respondents provided a consensus perspective on service availability and reimbursement. Descriptive proportions with full, partial, or no access were calculated. RESULTS: Thirty-nine countries responded (93%). Core diagnostics were widely available, but gaps persisted: MRI-guided biopsy was absent in 29% of countries and vacuum-assisted biopsy was fully reimbursed in 66%. Genomic assays were unavailable in 14% and not fully reimbursed in 35%. Public funding gaps were reported for PARP inhibitors (33%) and CDK4/6 inhibitors (26%). Immediate implant-based reconstruction and biological meshes lacked reimbursement in 21% and 33%, respectively. Despite broad availability of hypofractionated radiotherapy, 38% of countries still used per-fraction reimbursement. Psycho-oncology was limited in 35%, fertility preservation in 46%, and patient-reported outcome measures absent in 43%. CONCLUSION: Basic services are nearly universal, but gaps persist in advanced imaging, molecular testing, targeted therapies, radiotherapy reimbursement, reconstructive/oncoplastic surgery, and survivorship care. PORTRAIT identifies practical targets for policy audit, reimbursement alignment, and resource stewardship. Findings reflect clinician perspectives from expert centres, potentially representing best specialist care rather than average national care, and are not population-representative estimates or direct measures of patient outcomes.

Humans↗

PubMed2026

Care Experience Disparities in Individuals With Lower Urinary Tract Symptoms: Systematic Review and Content Analysis.

OBJECTIVES: In this study, we aimed to characterize the landscape of the literature and describe lower urinary tract symptom (LUTS) care experiences using the Agency for Healthcare Research and Quality's (AHRQ's) patient experience framework, describe the characteristics of the studies, and identify critical knowledge gaps. METHODS: We performed a systematic search of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus of peer-reviewed publications from 1995 to 2024. The search terms were related to LUTSs, drivers of healthcare inequities, and the domains of the AHRQ. We then performed a content analysis of the included studies. RESULTS: Of the 4597 articles reviewed, we included 11 studies in the analysis. The most studied LUTS was urinary incontinence (10/11, 91%). Of the included studies, six were comparative, and most (4/6, 66.7%) found worse care experience in patients with limited English proficiency and low socioeconomic status. When examining the studies using the care experience framework of the AHRQ, the most frequently evaluated domains of care experience were communication with clinicians (8/11, 73%) and access to care (8/11, 73%). For communication with clinicians, language barriers (3/11, 27%) and symptom minimization by clinicians (3/11, 27%) were common, especially among patients with limited English proficiency and of older age, respectively. In regard to access to care, concerns about healthcare costs (5/11, 45%) and patients' fear or embarrassment about accessing LUTS care (4/11, 36%) were commonly occurring themes, especially among racially minoritized groups. CONCLUSIONS: The findings of this systematic review demonstrated that patients with limited English proficiency, older age, low socioeconomic status, and racially minoritized backgrounds have poor LUTS care experiences.

Humans↗

PubMed2025

A Systematic Review of Help-Seeking Barriers for Racial-Ethnic Minority Caregivers Accessing Autism Diagnostic and Intervention Services.

Caregivers play an essential role in early help-seeking and intervention for children with Autism Spectrum Disorder (ASD). Caregivers, therefore, provide a crucial role in helping to address the racial and ethnic disparity identified in accessing ASD intervention and diagnostic services (Bejarano-Martín et al., Journal of Autism and Developmental Disorders 50(9), 3380-3394, 2020). Unfortunately, racial-ethnic minority caregivers of children with autism (CCA) are less likely to contact a physician or healthcare professionals about their concerns and more likely to delay their contact to have their child evaluated (Zeleke et al., Journal of Autism and Developmental Disorders 49(10), 4320-4331, 2019). However, little evidence exists to explain why such a gap exists in the help-seeking behaviors between White and racial-ethnic minority CCA. To address this knowledge gap, we conducted a systematic literature review to identify articles that have studied barriers in help-seeking for racial-ethnic minority CCA. A broad literature search across four databases was conducted (i.e., PubMed, PsycINFO, Education Resources Information Center, and Child Development and Adolescent Studies). The coding team identified 17 articles on help-seeking barriers for racial-ethnic minority CCA. A thematic analysis was used to narratively synthesize the help-seeking barriers identified across these 17 studies. Four themes emerged from our findings: logistical barriers, provider competence, ASD literacy, and cultural stigma. We also provided clinical recommendations for healthcare providers working with families with racial-ethnic minority CCA.

Humans↗

PubMed2026

Orofacial Cleft Disparities in American Indian and Alaska Native Populations: A Systematic Review and Meta-Analysis.

ObjectiveTo evaluate the prevalence, access to care, and health outcomes of orofacial clefts (OFCs) among American Indian and Alaska Native (AI/AN) populations through a systematic review and meta-analysis.DesignSystematic review and meta-analysis performed in accordance with PRISMA 2020 guidelines and registered with PROSPERO (CRD420251035364).SettingUS-based population registries, hospital databases, and institutional or community-level retrospective studies involving AI/AN populations.Patients and ParticipantsAI/AN individuals with OFCs compared with non-Hispanic White patients.InterventionsPrimary cleft lip and palate repair, secondary cleft-related procedures, and multidisciplinary cleft care.Main Outcome Measure(s)Prevalence of OFCs, timing of cleft surgery, discharge disposition, access to specialists, and qualitative determinants of disparities.ResultsEighteen studies including more than 1985 AI/AN patients were identified. Meta-analysis of 5 studies estimated a pooled OFC prevalence of 15 per 10 000 live births (95% confidence interval: 5-49), with substantial heterogeneity (I2 = 99.8%). Individual studies reported significantly higher OFC prevalence in AI/AN populations compared to non-Hispanic Whites (odds ratio range: 1.44-2.68). Geographic maldistribution of craniofacial-trained surgeons, increased odds of nonhome discharge, and delayed cleft palate repair were consistently observed barriers. Qualitative analyses highlighted structural inequities, perceived racism, and lack of culturally responsive care as major contributors to disparities.ConclusionsAI/AN populations face a disproportionately high burden of OFCs alongside structural barriers to timely, culturally competent care. Addressing these disparities requires community-engaged, multidisciplinary interventions that improve geographic access and integrate culturally responsive approaches to care.

Humans↗

PubMed2026

Disparities in guideline-adherent cardiovascular preventive care for people with diabetes: A systematic review and meta-analysis.

BACKGROUND: Clinical practice guidelines offer guidance on delaying the progression of cardiovascular disease in people living with diabetes. We sought to determine whether guideline-recommended cardiovascular preventive care for people living with diabetes differs according to sociodemographic indicators, globally. METHODS: We conducted a systematic review of studies that compared the sociodemographic characteristics of people diagnosed with type 1 or 2 diabetes who received cardiovascular preventive care as recommended by guidelines to those who did not. Sociodemographic predictors were defined by PROGRESS+ (an equity framework). We searched MEDLINE, EMBASE, and APA PsychInfo from 2010 to January 21, 2026. Studies were screened independently by two people. One person assessed the risk of bias and extracted data, and another verified. We pooled results using a random-effects model and assessed the certainty of evidence using GRADE. RESULTS: Twenty-five studies were included. Meta-analyses showed female, Black, and Hispanic individuals had slightly lower odds of receiving guideline-recommended prescriptions for lipid-lowering medication compared to Male, and White individuals, respectively (OR:0.89, 95%CI:0.79,1.00, moderate certainty; OR:0.78, 95%CI:0.74,0.81, high certainty; OR:0.86, 95%CI:0.59,1.26, low certainty). Individuals aged 18-45 years had moderately lower odds (OR:0.33, 95%CI:0.19,0.57, moderate certainty), no observed association for Asian individuals. Asian individuals had moderately lower odds of antihypertensive medication prescription (OR:0.42, 95%CI:0.38,0.46, high certainty). Evidence suggests likely no association between HbA1c testing and sex/gender or between sex/gender and lipid panel testing. CONCLUSIONS: Some disparities in guideline-recommended cardiovascular preventive care among people living with diabetes were found. These results are consistent with previous reviews and highlight the need to ensure guidelines consider equity and with improved dissemination.

Humans↗

PubMed2026

Latin American consensus on the medical oncologic management of early-stage HR+/HER2- breast cancer: Addressing regional disparities in Spanish-speaking countries.

PURPOSE: Substantial disparities persist in managing early-stage hormone receptor-positive, HER2-negative (HR+/HER2-) breast cancer across Spanish-speaking Latin America, including limited access to genomic testing, systemic therapies, and fertility preservation. The Latin American Breast Cancer Association (LABCA) convened an expert panel to produce the first consensus tailored to Spanish-speaking countries. METHODS: A literature review (Embase, PubMed, Scopus, ClinicalKey, LILACS; 2014-2025), informed by ESMO/ASCO/NCCN/SEOM guidelines and registered in PROSPERO (CRD42024565706), supported statement development. A steering committee of three experts of Spanish nationality supervised the process. Twenty-one specialists from 11 countries participated in a modified Delphi process; 31 items were voted in Round 1 and 25 statements were retained within scope. Consensus was pre-defined as ≥80% agreement (or median 7-9), with a mean/outlier rule reported alongside. RESULTS: Applying the ≥80% rule, 22 of 25 statements (88%) reached full consensus; three (1.3, 2.4, 3.3; 75-76%) were near-consensus and retained with caveats. Recommendations integrated clinicopathologic and molecular factors to guide risk stratification; genomic assays were reserved for selected scenarios and discouraged in very low-risk tumors or ≥4 positive lymph nodes. Consensus also covered ovarian suppression plus endocrine therapy, fertility preservation, sexual-health and genetic evaluation, and adjuvant CDK4/6 and PARP inhibitors when accessible. Marked heterogeneity in access was documented by country and sector. CONCLUSION: This consensus provides the first region-specific, evidence-based, resource-adapted recommendations for early-stage HR+/HER2- breast cancer in Spanish-speaking Latin America, aiming to reduce disparities and strengthen equitable oncology care.

Humans↗

PubMed2026

Tele-Oncology in the Post-Pandemic Era: Clinical Integration, Access Disparities and Medico-Legal Accountability.

PURPOSE OF THE REVIEW: Tele-health has evolved from a marginal tool confined to rural populations and selected follow-up programs into a structurally integrated component of modern cancer care. Prior to COVID-19, its adoption was constrained by regulatory fragmentation, non-uniform reimbursement, and licensure barriers. This narrative review evaluates the evolutionary integration of tele-health in oncology post-COVID-19, examines digital disparities across patient populations, and addresses the medico-legal implications of this integration, with the objective of providing a comprehensive and clinically actionable framework for the governance of virtual oncology care. RECENT FINDINGS: The pandemic acted as a global catalyst, driving telehealth to over 50% of oncology outpatient encounters in some settings, before stabilising post-pandemic at approximately 10-20% of consultations within hybrid care models. Evidence supports meaningful clinical benefits - improved access to specialist services, reduced travel burden, and sustained continuity of care - with outcomes comparable to in-person care in postoperative follow-up, symptom monitoring, and survivorship. However, persistent disparities in device availability, connectivity, and digital literacy disproportionately affect older, rural, and socioeconomically disadvantaged patients, raising the risk that geographic inequalities are replaced by technological ones. From a medico-legal standpoint, the remote modality does not modify the applicable standard of care, yet restricted physical examination and reliance on patient-reported data introduce risks of diagnostic delay and incomplete clinical assessment, with direct implications for professional liability, data protection under HIPAA and GDPR, cross-border licensure, and multi-party accountability across physicians, institutions, and technology providers. Tele-oncology has become a permanent structural feature of modern cancer care, offering demonstrable benefits in access, continuity, and patient satisfaction. Yet its integration has been uneven, its governance remains fragmented, and its medico-legal landscape is still evolving. Realising the full potential of virtual oncology care - equitably and safely - requires coherent regulatory frameworks, sustained investment in digital infrastructure, and explicit attention to the populations at greatest risk of being left behind.

Humans↗

PubMed2026

Patient and hospital factors associated with disparities in acute stroke treatment in community and academic hospitals.

BACKGROUND: Systemic barriers may affect identification, emergency transportation (EMS), and care coordination for people with stroke. We assessed patient- and hospital-level factors for associations with pre-hospital and emergency department care. We compared trends for patients presenting to an academic medical center (AMC) versus community hospitals (CHs). METHODS: We conducted a retrospective cohort study at an AMC (Tufts Medical Center) with 542 patients aged ≥18 years hospitalized with acute ischemic stroke or transient ischemic attack between 1/1/2018-12/31/2020 who presented directly to AMC or presented to AMC as a transfer from initial contact CHs. Primary outcomes were EMS use, stroke code activation, door-to-CT time, and door-to-needle time. RESULTS: AMC patients identifying as non-Hispanic Asian (odds ratio (OR) = 0.25; 95% confidence interval (CI) = 0.13-0.47) and Hispanic (OR = 0.19; 95% CI = 0.05-0.72) and CH non-Hispanic Black/African-American patients (OR = 0.17; 95% CI = 0.05-0.62) were less likely to use EMS compared to non-Hispanic white patients. Patients with non-English primary language were less likely to use EMS (OR = 0.38; 95% CI = 0.23-0.63) compared to English-speaking patients in both hospital settings. CH Hispanic patients were less likely to have stroke code activation (OR = 0.24; 95% CI = 0.05-0.86) compared to non-Hispanic white patients. CH patients were less likely to have stroke code activation (OR = 0.12; 95% CI = 0.07-0.19), had 31% shorter door-to-CT time (95% CI = 15-43% shorter), and had 29% longer door-to-needle time (95% CI = 5-58% longer). CONCLUSION: Patient-level factors and hospital setting were associated with differences in acute care suggesting opportunities for community outreach on EMS use, interventions to alleviate language barriers, and a need to address systemic biases.

Humans↗

PubMed2026

Sociodemographic trends in prostate cancer: insights from the All of Us Research Program.

BACKGROUND: Prostate cancer disproportionately affects vulnerable populations. The All of Us Research Program (AoURP) is a database that aims to encapsulate the diversity of the United States. To explore the utility of this dataset in assessing prostate cancer disparities, we investigated whether treatment usage, disease progression, and genomic research participation vary across sociodemographic factors among AoURP participants with prostate cancer. METHODS: We identified AoURP participants with prostate cancer. Genomic research participation in AoURP, treatment usage, time-to-treatment, and time-to-metastasis were assessed by demographics and distance from a National Cancer Institute-designated comprehensive cancer center. Multivariable logistic regression and Cox proportional hazards regression were performed to evaluate treatment usage and time-to-treatment and time-to-metastasis, respectively. RESULTS: We observed lower genomic data availability in Black vs White patients (P < .001). In multivariable analyses, patients residing more than 80 miles from an NCI-designated comprehensive cancer center were less likely to receive androgen receptor pathway inhibitors (odds ratio [OR] = 0.30, 95% CI = 0.14 to 0.66; P = .002) and bone targeting agents (OR = 0.46, 95% CI = 0.30 to 0.70; P < .001) but more likely to undergo prostatectomy (OR = 1.97, 95% CI = 1.43 to 2.71; P < .001) than those residing less than 40 miles away. These patients also initiated treatment faster (hazard ratio [HR] = 1.54, 95% CI = 1.27 to 1.87; P < .001) and developed metastasis slower (HR = 0.58, 95% CI = 0.40 to 0.86; P = .006). Black patients were less likely to receive radiation (OR = 0.45, 95% CI = 0.23 to 0.88; P = .020), prostatectomy (OR = 0.65, 95% CI = 0.44 to 0.96; P = .028), and bone targeting agents (OR = 0.65, 95% CI = 0.45 to 0.93; P = .018) than White patients. CONCLUSIONS: Prostate cancer treatment usage, disease progression, and genomic research participation varied between demographic populations. As AoURP matures, additional studies may leverage future data releases to confirm these findings.

Aged↗

PubMed2025

Nonadherence to guidelines for genetic testing in families with ovarian cancer shows racial bias.

PURPOSE: The National Comprehensive Cancer Network (NCCN) recommends germline genetic testing for individuals at risk for hereditary ovarian cancer. We sought to determine the proportion and characteristics of individuals meeting testing criteria in a multicenter biobank who were appropriately offered testing. METHODS: In this retrospective cohort study, we identified Mass General Brigham Biobank participants meeting genetic testing criteria per NCCN guidelines. Logistic regression was used to analyze sociodemographic factors associated with which participants were offered testing, completed testing, and had a family history that matched their self-report documented in the electronic medical record. RESULTS: Most eligible participants (909/1441, 63.1%) were not offered genetic testing. Participants who were Black or Hispanic had a lower likelihood of being offered testing. Compared with self-report, 988 (68.6%) participants had a family history of ovarian cancer documented in their electronic medical record. Older age, Hispanic ethnicity, and public insurance use were associated with decreased likelihoods of accurate family history documentation. Correct documentation was associated with an increased likelihood of being offered testing. CONCLUSION: The majority of participants in this study did not receive NCCN-compliant care. Germline genetic testing for hereditary ovarian cancer screening is underutilized and access to this testing is currently inequitable.

Adult↗

PubMed2026

The effectiveness of digital health interventions for type 2 diabetes in underserved populations: A systematic review and meta-analysis.

This systematic review and meta-analysis of 12 randomized controlled trials (1835 participants) evaluated whether digital health interventions (DHIs) improve glycemic control among underserved adults with type 2 diabetes (T2D), including racial/ethnic minority, low-income, Medicaid-insured, rural, and low-health-literacy populations. Searches of PubMed, Embase, and the Cochrane Central Register of Controlled Trials from inception to December 20, 2025 identified eligible parallel-group randomized controlled trials reporting change in hemoglobin A1c (HbA1c). Two reviewers independently screened studies, extracted data, and assessed risk of bias using the revised Cochrane Risk of Bias 2 tool. Random-effects meta-analysis showed that DHIs produced a modest but statistically significant HbA1c reduction versus control (mean difference, -0.37 %age points; 95% CI, -0.44 to -0.30; P < .0001; equivalent to -4.0 mmol/mol). Heterogeneity was moderate-to-substantial (I² = 69.9%). Subgroup analyses suggested directionally similar effects by population group and intervention modality, but interpretation was limited by study-level data and the small number of trials. Funnel-plot inspection and Egger's test (P = .31) did not suggest major small-study effects, although power was limited. Overall certainty for HbA1c was moderate. DHIs may support more equitable diabetes care when implemented with cultural tailoring, language access, digital-literacy support, and technology-access safeguards.

Humans↗

PubMed2026

Leading with Innovation: Maternal Health Transformation in New York City Health + Hospitals.

New York City's (NYC) maternal health crisis drew close attention in the late 2010s, driven by alarming data: Approximately 30 women died annually during childbirth in NYC, Black non-Hispanic women were 12 times more likely to die than white women, and more than 3,000 women experienced life-threatening birth complications each year. In response, NYC committed $12.8 million in July 2018 to reduce maternal mortality and eliminate racial disparities.NYC Health + Hospitals (H+H)-the nation's largest public health system, serving 1.1 million patients annually with roughly 15,000 births per year-became the primary vehicle for this initiative. With 80 percent of the system's deliveries covered by Medicaid and a patient population that is 51.2 percent Hispanic and 27.1 percent Black, H+H is uniquely positioned to lead the fight against maternal health inequity.Three flagship programs anchor H+H's response to the city's maternal mortality rate. The OB Simulation Program, launched in 2012 and expanded in 2018, was the first in the nation to use mannequins of color to train thousands of providers in obstetric emergencies. The Maternal Home Program, piloted at H+H's Kings County Hospital in 2019 and scaled system-wide by 2021, has served more than 10,341 patients, generating more than 33,000 referrals for social, behavioral health, and community resources. The Cardio-Obstetrics Program located at Kings County Hospital targets cardiovascular disease-the leading cause of maternal death among Black women-through screening, education, and community outreach. These programs are a health equity imperative, made more urgent by impending federal Medicaid cuts resulting from the H.R.1 One Big Beautiful Bill Act (passed on July 4, 2025).

Humans↗

PubMed2025

Systems Factors Contributing to Racial/Ethnic Disparities in Maternal Health: A Systematic Review.

INTRODUCTION: Despite ongoing efforts to reduce adverse maternal outcomes, including maternal mortality and severe maternal morbidity, racial/ethnic disparities in outcomes persist in high-income countries, including the United States (US) and Canada. Limited research has examined hospital-level factors that may drive disparities and contribute to adverse outcomes. This systematic review summarizes factors within the health system contributing to adverse outcomes and racial/ethnic disparities in the US and Canada to inform future policies and practices. METHOD: We searched SCOPUS, PubMed, EBSCOhost, and ProQuest Healthcare Administration for studies that reported hospital-level factors contributing to adverse maternal outcomes and racial/ethnic disparities. The review followed a two-stage screening process. The risk of bias of the included studies was evaluated using the Mixed Methods Appraisal Tool. The System Engineering Initiative for Patient Safety (SEIPS) 2.0 framework guided the identification and categorization of factors. RESULTS: Of 2441 studies retrieved, 30 met the inclusion criteria. Twenty-eight studies were conducted in the US, and 2 were conducted in Canada. The review included 16 qualitative, 11 quantitative, and 3 mixed-methods studies. We identified 60 factors associated with different system components, including person(s) (12%), tasks (28%), tools and technology (7%), internal environment (10%), organization (28%), and external environment (15%). Shortage of resources, including staffing, poor care coordination, and discriminatory organizational practices, were key factors described in the studies. CONCLUSION: Addressing health system factors in addition to broader societal factors is important to reduce adverse outcomes and promote equity for all women and birthing persons.

Humans↗

PubMed2025

Disparities in Outcomes for Patients With Inflammatory Bowel Disease at a Private vs Public Hospital in New York City.

BACKGROUND: In patients with inflammatory bowel disease (IBD), social determinants of health contribute to health inequalities. We aimed to compare patients with IBD treated at a private nonprofit vs public hospital in New York City. METHODS: We performed a retrospective study of adult patients with Crohn's disease or ulcerative colitis with established IBD care. Patient demographics, disease characteristics, healthcare utilization, treatment modalities, and clinical outcomes were collected. Using a series of linear mixed and logistic models, the differences between care at a private nonprofit vs public hospital were assessed while controlling for factors that differed between them. RESULTS: Our study included 418 patients with IBD, 209 from each hospital. Compared with public hospital patients, private hospital patients were more likely to be White, be non-Hispanic, and have private insurance (all P = .0005) and less likely to face housing instability (P < .0001), face unemployment (P = .0004), be current smokers (P = .03), or be foreign born (P < .0001). Patients at the private hospital were more likely to have multiple anti-tumor necrosis factor (P = .0001) and biologic use (P < .0001). Public hospital patients were less likely to be considered endoscopically adherent (odds ratio [OR], 0.377; P = .001) and more likely to visit the emergency department (OR, 5.01; P < .0001) and be hospitalized (OR, 1.92; P = .05). CONCLUSIONS: Our study is the first to identify significant differences in patient demographics, disease phenotype, treatments and clinical outcomes between patients treated for IBD at a private nonprofit vs public hospital. Our data suggest that social determinants of health drive disparities in the utilization of healthcare facilities.

Humans↗

PubMed2025

Urban mental health: a position paper of the European psychiatric association.

BACKGROUND: Urbanization, the shift of a growing population into urban areas, is shaping global development across infrastructure, health, and sustainability. Although it brings economic growth, innovation, and improved access to services, it may also impact mental health. METHODS: The present article was prepared on behalf of the European Psychiatric Association and explores the complexity of associations between urbanization and mental health, highlighting both potential risks and opportunities for improvement. RESULTS: Urban growth often leads to increased population density, social fragmentation, and environmental stressors, including noise, pollution, and reduced green spaces, all of which might account for worsening mental health. Urban residents might be at risk of various mental disorders due to these stressors, accompanied by the risk of social disconnection. Moreover, socioeconomic disparities in urban settings can lead to unequal healthcare access, further contributing to these challenges. However, urbanization also offers unique opportunities to improve mental health through better resource allocation, innovative healthcare solutions, and community-building initiatives. Indeed, cities might serve as areas for mental health promotion by integrating mental health services into primary care, utilizing digital health technologies, and fostering environments that promote social interactions and well-being. Urban planning that prioritizes green spaces, safe housing, and accessible public transportation holds the potential to mitigate some risks related to urban living. CONCLUSIONS: While urbanization presents significant challenges to mental health, it also provides grounds for transformative interventions. Addressing the mental health needs of urban populations requires a multifaceted approach that includes policy reform, community engagement, and sustainable urban planning.

Humans↗

PubMed2025

Artificial intelligence in healthcare and medicine: clinical applications, therapeutic advances, and future perspectives.

Healthcare systems worldwide face growing challenges, including rising costs, workforce shortages, and disparities in access and quality, particularly in low- and middle-income countries. Artificial intelligence (AI) has emerged as a transformative tool capable of addressing these issues by enhancing diagnostics, treatment planning, patient monitoring, and healthcare efficiency. AI's role in modern medicine spans disease detection, personalized care, drug discovery, predictive analytics, telemedicine, and wearable health technologies. Leveraging machine learning and deep learning, AI can analyze complex data sets, including electronic health records, medical imaging, and genomic profiles, to identify patterns, predict disease progression, and recommend optimized treatment strategies. AI also has the potential to promote equity by enabling cost-effective, resource-efficient solutions in low-resource and remote settings, such as mobile diagnostics, wearable biosensors, and lightweight algorithms. Successful deployment requires addressing critical challenges, including data privacy, algorithmic bias, model interpretability, regulatory oversight, and maintaining human clinical oversight. Emphasizing scalable, ethical, and evidence-driven implementation, key strategies include clinician training in AI literacy, adoption of resource efficient tools, global collaboration, and robust regulatory frameworks to ensure transparency, safety, and accountability. By complementing rather than replacing healthcare professionals, AI can reduce errors, optimize resources, improve patient outcomes, and expand access to quality care. This review emphasizes the responsible integration of AI as a powerful catalyst for innovation, sustainability, and equity in healthcare delivery worldwide.

Humans↗

PubMed2026

Healthcare Access and Safety Training Gaps Among H-2 A Visa Agricultural Workers in Georgia.

The H-2 A Temporary Agricultural Workers Program, which supplies seasonal labor essential to U.S. food security, has grown over 230% in the past decade but is excluded from the National Agricultural Workers Survey. Although safety training is federally mandated and H-2 A workers are eligible for Affordable Care Act (ACA) marketplace coverage, compliance and healthcare access among these workers remain poorly documented. The aim of this pilot study was to assess workplace safety training, heat acclimatization practices, health insurance awareness and enrollment, and healthcare utilization among H-2 A workers in Georgia. In summer 2024, bilingual research assistants orally administered a cross-sectional Spanish-language survey to 51 H-2 A workers at a South Georgia laundromat, in partnership with the Latino Community Fund Georgia. The survey assessed demographics, occupational characteristics, safety training, heat acclimatization, health insurance awareness and enrollment, and healthcare utilization. Findings are self-reported. Among participants, 41% reported not receiving federally mandated pesticide safety training, and 59% received heat illness prevention training. Heat acclimatization was inadequate for 53% (29% received none). Additionally, 53% did not know the nearest hospital, 43% reported having health insurance, and 25% were unsure of their health insurance status. Overall, 71% had never visited a doctor's office, and of 22 insured workers, only 1 (2%) had used benefits this season. Substantial gaps in workplace safety training, heat acclimatization, and healthcare access were observed in this pilot study, consistent with prior evidence of persistent disparities in this population. Community-based outreach, bilingual health navigation, and market-based labor accountability models warrant further investigation to improve protections for H-2 A workers.

Agricultural workers↗