Dear clients and friends: Given your interest in health and medicine, we would like to share with you our collection of the most interesting perspectives on our industry's trends and developments. We are happy to share them with you — and hope you share your thoughts with us.

1. “The Mortality Penalty” 

Black infants are more likely to die under the care of white doctors than Black doctors. The National Academy of Sciences reports:

Researchers reviewed 1.8m hospital birth records in Florida from 1992 to 2015, and established the race of the doctor in charge of each newborn’s care. When cared for by white doctors, black babies are about three times more likely to die in the hospital than white newborns. This disparity halves when black babies are cared for by a black doctor.

Part of the problem, the research posits, is a breakdown in both trust and communication between parents and doctors. Might Black-staffed clinics in Mississippi offer a better model? The San Francisco Gate profiles Dr. Bacon, a primary care provider in central Mississippi:

Over generations, Dr. Bacon has built trust in a community generally skeptical of the health care system and made her Black patients feel they have a safe place to go for medical care.

“It’s meaningful to be taken care of by someone who looks like you, who understands you,” one patient said. “Other doctors go into the exam room, and they don’t ask your name. And me, when I go there and be treated that way, I’m not going back no more.”

2. What’s Next for Psychiatry?

Provocative, contentious, and often unsympathetic history of psychiatry and a path for its future. All in a blog! By a veteran public health official! Topics include Freud, Darwin, the DSM, and the future of “evolutionary psychiatry”:

Psychiatric therapies have never been atheoretical – psychiatrists have always justified their treatments with some school of thought: Freudian psychodynamic theories placed blame on early childhood and subconscious urges; behaviourism justified the application of pain to try and train people out of wrongthink; and more recently, chemical imbalance theories were used to advertise pharmaceuticals, despite the narrative of simple dopamine and serotonin dysfunctions having been long dismissed in academic circles. Recent advances in genetics and neuroscience have provided more evidence and complexity, but no promising new theories. Psychiatry today can be considered a discipline in crisis, surviving only because psychological and pharmaceutical treatments are effective for some people, some of the time, and so we still need them. The way is open for a new paradigm in psychiatric theorising.

3. Are We Throwin’ Away Our Shot?

The CDC has announced that COVID-19 vaccines may be available as soon as November. Will public health departments be prepared to do their part in giving the shots? Undark investigates, and what it finds is not encouraging:

Health departments that have been underfunded for decades say they currently lack the staff, money and tools to educate people about vaccines and then to distribute, administer, and track doses to some 330 million people. Nor do they know when, or if, they’ll get federal aid to do that. 

Then there’s the basic question of scale. The federally funded Vaccines for Children program immunizes 40 million children each year. But for the U.S. to reach herd immunity against the coronavirus, most experts say, the nation would likely need to vaccinate roughly 70% of Americans, which translates to 200 million people and — because the first vaccines will require two doses to be effective — 400 million shots.

4. Breaking News: Payers and Advocates Disagree!

California’s state legislature has passed a mental health “parity” law that would require payers to cover mental health conditions similar to other diseases. Advocates say this bold legislation would help people access care before a crisis. The California senator who introduced the bill makes a case for why it’s needed:

We need to go beyond giving insurance coverage only when someone is in crisis and going to the psych emergency room. We need to get people mental health and addiction help early, when we can nip it in the bud, before they lose their job, before they lose their housing, before they lose their family. And we need to get people the care they need.

Meanwhile, payers argue that this bill solves the wrong problem:

The California Association of Health Plans says that arguments that mental health treatment isn't already on par with medical care in terms of insurance reimbursement "couldn't be further from the truth" and that language in the bill could end up limiting treatment options. It says meeting growing demand for care will require an investment in a bigger mental health workforce, among other things, which the bill does not address.

Governor Newsom will soon decide who he thinks is right.

5. U–S–A! U–S–A! 

It’s not just COVID. The US trails peer countries on many health metrics, according to new data from the Kaiser Family Foundation and the Peterson Center on Healthcare:

While inconsistent and imperfect metrics make it difficult to firmly assess system-wide health quality in the U.S., a review of the available data prior to the onset of the pandemic suggests that in most of these measures, the U.S. continued to lag behind comparably wealthy and sizable countries. As rates of all-cause mortality, maternal mortality, and years of life lost have stagnated or increased over time, the gap has widened between the U.S. health system and those of its peers.