- N Engl J Med 2021; 385:2209-2211
As we enter a new stage of pandemic response and recovery — in which we must address issues of racial health inequities, frontline health care infrastructure, and community preparedness — what constitutes adequate support for the U.S. health care safety net?
Inequitable Access to Hospital Care — Protecting Disadvantaged Populations during Public Health EmergenciesN Engl J Med 2021; 385:2211-2214
Load balancing among hospitals is a critical public health intervention during emergencies: failing to balance patient loads will cause unnecessary loss of life, particularly in historically marginalized racial and ethnic groups and rural or low-income communities.
- N Engl J Med 2021; 385:e80
Traditional Medicare still lacks dental coverage, which has contributed to inequities in pain, edentulism, and unmet need among lower-income people, people of color, and older adults. The federal government is now closer than ever to enacting a Medicare dental benefit.
- N Engl J Med 2021; 385:2113-2116
Policy has been critical to achieving major public health advances, including in tobacco control, maternal and child health, and injury prevention. The opioid crisis illustrates five steps essential for using policy to produce substantial gains in population health.
- N Engl J Med 2021; 385:1925-1927
In this Graphic Perspective, a physician traveler responding to a medical crisis on the train he’s taking is moved and inspired by the conductor whose quick action, dedication, and compassion save the day.
- N Engl J Med 2021; 385:1825-1827
Given the parade of SARS-CoV-2 variants, their increasing transmissibility, and concern about antigenic changes affecting vaccine protection, we need long-term plans for dealing with this virus. Pandemic and seasonal influenza may provide appropriate models.
History of Medicine: When Women and Children Made the Policy Agenda — The Sheppard–Towner Act, 100 Years LaterN Engl J Med 2021; 385:1827-1829
One hundred years ago, the Sheppard–Towner Maternity and Infancy Protection Act launched a striking policy experiment. Had the program survived, the country might have developed a model for promoting child health that integrated preventive care with social services.
- N Engl J Med 2021; 385:1737-1749
Equations for estimating GFR with serum creatinine overestimate measured GFR in Blacks. The authors report new equations, without race as an inflation factor, using cystatin C and creatinine that reduced errors in estimation between Black participants and non-Black participants.
- N Engl J Med 2021; 385:1804-1806
In the wake of the racial reckoning since the spring of 2020 in the United States, efforts have emerged to identify hidden structural determinants of systemic racism in medicine. Such efforts have led to examination of traditional medical algorithms that incorporate race modifiers and may have led to disparities in...
- N Engl J Med 2021; 385:1750-1760
The use of race in equations that estimate the glomerular filtration rate is problematic. In this study, the use of the serum creatinine level to estimate the GFR without race (or genetic ancestry) introduced systematic misclassification. Estimating GFR with cystatin C generated similar results but eliminated negative consequences of race-based...
- N Engl J Med 2021; 385:1729-1732
Populations are composed of myriad subpopulations, each with its own health profile. A key subpopulation that must be considered in efforts to enhance population health is children, a group whose characteristics pose distinct opportunities and challenges.
- N Engl J Med 2021; 385:1633-1636
Chronic-disease care in the United States doesn’t support optimal patient health and experience, especially for marginalized populations. Too often, care systems are based on tradition, self-interest, and revenue generation.
- N Engl J Med 2021; 385:1636-1639
The latest Child Abuse Prevention and Treatment Act reauthorization bill would change the way families of substance-exposed infants are treated. The Biden administration could also leverage prevention and public health systems to achieve the policy’s objectives.
- N Engl J Med 2021; 385:1537-1539
The United Kingdom recently amended its eligibility criteria for blood donation to screen out potential donors on the basis of individualized risk assessment rather than blanket criteria excluding all men who have had sex with men. The United States should follow suit.
- N Engl J Med 2021; 385:1543-1545
As the new school year approaches, an immunocompromised mother faces a different risk–benefit calculus from most moms in sending her son off to kindergarten during a pandemic. But having saved up her “risk dollars,” she is ready to spend some on a return to normalcy.
- N Engl J Med 2021; 385:1443-1445
Safe, affordable housing is a foundation of good health. But housing is often viewed as a commodity or a business, rather than as a social determinant of health. The Covid-19 pandemic both highlighted eviction as a public health crisis and exacerbated the problem.
- N Engl J Med 2021; 385:1526-1530
Building integrated translational pipelines that use data rapidly and effectively to address health effects of natural disasters will require substantial investment, which must rely on evidence of which approaches improve outcomes. But promising solutions are available.
- N Engl J Med 2021; 385:1429-1430
The Editors announce a new requirement for research studies published in Journal: a supplementary table that provides background information on the condition studied and on the representativeness of the study group. A sample table showing specific categories of information is provided.
- N Engl J Med 2021; 385:1345-1348
For researchers using observational data, a useful way to answer a causal question is to design the target trial that would answer it and then emulate its protocol. The example of the HIV-treatment-as-prevention strategy illustrates the benefits of this approach.
- N Engl J Med 2021; 385:1153-1155
To combat the pandemic, officials imposed extensive mitigation measures using their emergency powers. In response, more than 1000 suits challenged orders shuttering businesses, banning indoor worship services, restricting travel, and mandating mask wearing.