Issue link: https://beckershealthcare.uberflip.com/i/1431416
40 QUALITY IMPROVEMENT & MEASUREMENT COVID-19 death rate 2 times higher in rural America By Mackenzie Bean T he COVID-19 death rate is more than two times higher in rural parts of the country than it is in ur- ban areas, Kaiser Health News reported Sept. 30. This gap will likely grow wider because of declining access to healthcare in rural areas, public health ex- perts told the publication. As of Sept. 15, the seven-day average death rate for Americans in rural areas was .41 per 100,000 peo- ple, compared to .85 per 1,000 in rural areas. For its analysis, Kaiser Health News used data from Balti- more-based Johns Hopkins University and the Rural Policy Research Institute. Most rural areas weren't hit hard during the pandem- ic's first surge. However, death rates in rural America began outpacing those in urban areas after the virus spread nationwide and before vaccines were avail- able, according to the Rural Policy Research Institute. Overall, about 1 in 434 rural Americans have died of COVID-19 during the pandemic, compared to about 1 in 513 urban Americans. n Tuberculosis deaths rise for 1st time since 2005: 4 report findings By Mackenzie Bean T he pandemic has reversed years of global progress in treating and preventing tuberculosis, the World Health Organization said in an Oct. 14 report. Four findings: 1. About 10 million people develop tuberculosis annually. However, only 5.8 million people were diagnosed with tu- berculosis in 2020, down from 7.1 million in 2019. 2. The latest diagnostic figures represent levels not seen since 2012 and suggest that at least an estimated 4.1 million people have tuberculosis but have not been diagnosed or treated. 3. In 2020, 150,359 people received treatment for drug-re- sistant tuberculosis, a 15 percent decrease from 2019. 4. About 1.5 million people died from tuberculosis in 2020, the WHO estimates, which marks the first increase in global deaths since 2005. n Historically redlined districts tied to racial disparities in delivery rooms By Gabrielle Masson A merican women living in historically redlined ZIP codes have increased risk for both preterm and periviable births, according to a study published in JAMA Network Open Sept. 30. Researchers analyzed birth certificate data from nine New York counties from 2005 to 2018. ey then matched modern obstetric outcomes with regions classified by the gov- ernment for mortgage loan servicing based on racially discriminatory criteria from the 1940 Home Owners' Loan Corporation map. From 2005 to 2018, there were 64,804 live births among the 15 ZIP codes overlaying historically "redlined" regions. Six things to know: 1. e lowest overall preterm birth rate prev- alence — 217 of 2,873 births, or 7.55 percent — was in the ZIP code historically defined as "best" or "still desirable." 2. e highest overall preterm birth rate — 427 of 3,449 births, or 12.38 percent — was in the ZIP code historically defined as "hazardous." 3. These associations with preterm birth remained significant after controlling for poverty levels, educational attainment and parental race. 4. Increased risks include higher rates of preeclampsia, stillbirth, preterm birth, fetal growth restriction and maternal morbidity and mortality in Black women compared with white women. While disparities were recorded for other racial and ethnic groups, the differences between Black and white people are the most stark and persistent, the authors wrote in a study commentary. 5. ese findings suggest that historic discriminatory policies remain associated with poor obstetrical outcomes, and that intergenerational discrimination and disin- vestment continue to play a role in modern health disparities. 6. "is is an opportunity to begin to un- derstand how health inequities were and are created and allowed to persist," the study authors wrote. "While we, as clinicians, may not be responsible for these sources of health inequity, it is incumbent on each of us to recognize the systemic racism our pa- tients have experienced and seek out how to reduce the health inequities they incur." n