Journalist explores health inequities in medical photography

About Karen Blum

Karen Blum is AHCJ’s core topic leader on health IT. An independent journalist in the Baltimore area, she has written health IT stories for publications such as Pharmacy Practice News, Clinical Oncology News, Gastroenterology & Endoscopy News, General Surgery News and Infectious Disease Special Edition.

Georgina Gonzalez

Medical photographs are crucial to documenting disease in textbooks, journals and training medical students. But if inaccurate, physicians won’t get a clear enough picture of what disease looks like in people with different skin tones, which could impact health outcomes, wrote Georgina Gonzalez in her recent article published in The Verge.com, “Medical Photography is Failing Patients with Darker Skin.” The piece includes information about a recent journal article in which a dermatologist offers guidance for photographing skin conditions in people of color and describes how bias has been built into photography for decades. 

It was the first freelance pitch for Gonzalez, who works full-time as a news reporter for Becker’s Hospital Review. In a new “How I Did It,” she shares the story behind the story and her advice to AHCJ members writing about technology. (Responses have been lightly edited and condensed.)

How did you get the idea for this story?

I was an intern at NBC and was searching for news when I came across a cover photo that a news organization had posted of [businessman and former presidential candidate] Andrew Yang. People were complaining on Twitter about the photo and the color wash because he looked very yellow. It led to numerous racist stereotypes about Asians during the height of anti-Asian hate happening in the city. The organization apologized, but I remember seeing people in the thread saying, “Oh, it was the filter,” or “It’s because it was taken on a film camera.” Then, I became interested in how technology can produce an image that’s not representative, especially if it leans into racist tropes. 

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Busting myths about people with mental illness and criminal activity

About Katti Gray

Katti Gray (@kattigray) is AHCJ's core topic leader for behavioral and mental health. A former Rosalynn Carter Mental Health Journalism Fellow, Gray is providing resources to help AHCJ members expand their coverage of mental health amid ongoing efforts to de-stigmatize mental illness and to place mental health care on par with all health care.

Photo by Ricky Shore via Flickr.

One of the most widespread misconceptions about people with mental illness is that they are more likely to commit crimes than people without mental illness. Several studies have shown that the opposite is true. Overall, most crimes are committed by people who have no mental illness diagnosis; and people with mental illness are more likely to be crime victims than perpetrators.

The misconceptions, policymakers, reformers and researchers in this sphere say, are at least partly driven by news headlines about crimes committed by those with mental illness, especially the severest diseases. Schizophrenia is one of those severe illnesses. And, indeed, those with schizophrenia and related psychotic disorders are the likeliest of all people with mental illness to commit crimes.

That latter reality is at the center of a recently published JAMA Psychiatry study, “Association of schizophrenia spectrum disorders and violence perpetration in adults and adolescents from 15 countries: A systematic review and meta-analysis.” It newly spotlights the complicated, complex problem of crimes perpetrated by mentally ill people, even as it cautions against stigmatizing mental illness.

Study authors contend that the psychiatric needs of people with mental illness at risk for committing crimes go unmet precisely because the medical, law enforcement, and patient advocacy sectors — and the general public — have not confronted the facts. And, they argue, that news coverage of, say, those guilty of mass shootings sometimes has overstated the role/potential role of mental illness in those crimes. 

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AHCJ’s freelance committee launches “Lunch and Learn”

About Jeanne Erdmann and Barbara Mantel

Jeanne Erdmann (@jeanne_erdmann) is a member of AHCJ's board of directors and is chair of the freelance committee. Barbara Mantel (@BJMantel), an independent journalist, is AHCJ’s freelance community correspondent.

Photo by Jeffrey Beall via Flickr.

Freelancers can find all sorts of tips and resources on AHCJ’s Freelance Center, but there’s nothing like one-on-one interaction. Now AHCJ freelance members have a monthly opportunity to trade advice and share expertise.

Members of AHCJ’s freelance committee, including independent journalists Jeanne Erdman and her co-chair Andrea King Collier, have organized monthly Zoom meetings called Lunch and Learns. These informal sessions, designed to build skills and community, occur at 1:00 p.m. EST every third Thursday of the month.

Each session highlights a specific theme. The first session in January focused on how to plan work for the year. Forty-seven members attended, and many joined the discussion.

“I thought it was great. There were over 40 people on the call — some I knew, some I didn’t — and many seemed eager to participate and share knowledge,” said Karen Blum, an independent journalist and AHCJ’s health IT core topic leader.

The January session spotlighted strategies for revising current business plans. For example, some freelancers used Quickbooks to see which clients paid the most or had the worst contracts in the previous year. One writer took three weeks off in December to come back fresh. Another freelancer said she makes a list of objectives each January detailing where she wants to be at the end of the year.

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Tips for covering Medicare’s plan to limit coverage of controversial Alzheimer’s drug

About Kerry Dooley Young

Kerry Dooley Young (@kdooleyyoung) is AHCJ's core topic leader on patient safety. She has written extensively about the Food and Drug Administration, medical research, health policy and quality measurements. Her work has appeared in Medscape Medical News, Congressional Quarterly/CQ Roll Call and Bloomberg News.

Photo courtesy of the NIH Image Gallery via Flickr.

Medicare’s plan to restrict access temporarily to a controversial new Alzheimer’s drug is worth investigating.

Expect to see a flurry of activity from groups protesting this plan ahead of Medicare’s Feb. 10 deadline for comments on its plan for Biogen Inc.’s Aduhelm drug. In a proposed decision memo released on Jan. 11, officials at the Centers for Medicare and Medicaid Services (CMS) said they plan to limit payment for Aduhelm to cases where people participate in clinical trials. By April 11, CMS intends to finalize its national coverage decision (NCD) for Aduhelm and an expected crop of similar follow-on drugs for Alzheimer’s disease.

In writing about the debate about Medicare coverage of Aduhelm, you should:

  1. Help your audience understand what the data gathered so far say about Aduhelm.
  2. Clarify the different roles and authorities of CMS and the FDA regarding Aduhelm.
  3. Provide important context about the state of Alzheimer’s disease research.

Biogen and some patient groups are seeking to pressure CMS to revise its decision, in part by rallying public support. Zach Brennan of Endpoints News reported CMS’ proposed decision led by Biogen to activate “a comprehensive plan” to reach doctors, patient advocates and others with an interest in how the federal government pays for medicines.

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Two new studies address fertility and COVID vaccines

About Tara Haelle

Tara Haelle (@TaraHaelle) is AHCJ's medical studies core topic leader, guiding journalists through the jargon-filled shorthand of science and research and enabling them to translate the evidence into accurate information.

Photo by Johannes Jander via Flickr.

One of the most persistent concerns about potential adverse effects from the COVID-19 vaccines has been whether they will affect the reproductive system, particularly fertility. Fortunately, two new studies suggest there is no evidence that any of the vaccines can impact fertility.

As I wrote years ago in Forbes, anxiety about vaccines causing problems with fertility is not new. At that time, in 2014, a resurgence of fears about the pertussis vaccine causing infertility in Kenya was in the news, but that was just one incarnation of a fear that’s been around as long as vaccines have. In fact, it’s one of the oldest and most lingering fears about vaccines because fertility has been such a precious, treasured health status for centuries and is, therefore, something people, understandably, want to protect.

The first study, published Jan. 5 in Obstetrics and Gynecology, addresses the issue tangentially by reporting on findings of COVID-19 vaccines’ impact on menstrual cycles. Early in the vaccine rollout, anecdotal evidence suggested an uptick in breakthrough bleeding even for people taking hormones that should have suppressed periods or in people who had entered perimenopause. People with otherwise normal cycles experienced early or particularly heavy periods after getting vaccinated, prompting an investigation into whether there was a link between vaccination and heavier, earlier, or longer periods.

The researchers analyzed data from six menstrual cycles — three before vaccination and three post-vaccination—in 3,959 people, about two-thirds of whom were vaccinated. Just over half the vaccinated people got the Pfizer vaccine, a third got Moderna, and 7% got Johnson & Johnson. While the researchers did detect a slight difference in cycle length, it was by less than one day, suggesting no significant impact. While the study doesn’t directly address fertility effects, menstruation is one indicator of potential fertility health, so the findings should be reassuring to those concerned about it.

The second publication, an NIH-funded study appearing Jan. 20 in the American Journal of Epidemiology, compared more than 2,000 couples with varying infection and vaccination (1 dose, 2 doses, no doses) status and took into account a wide range of covariates that might cause confounding. The results showed no difference in the likelihood of conceiving where one or both partners had received one or two doses of the vaccine, compared with couples where neither were vaccinated.

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