Demographic diversity of genetic databases used in Alzheimer's disease research.

For several years, experts have warned about the lack of diversity in genetic research databases, and researchers have devoted time and resources to recruiting subjects from underrepresented subgroups. In this study, we review published reports in academic journals of genetic studies of Alzheimer's disease to note whether demographic diversity was indicated in the reports and, if so, the extent of representation of non-European subjects over the period from 1997 to 2022. We use multivariate regression analysis to analyze changes over time and to explain variation across studies. Our analysis indicates that reported diversity has not changed over time. Rather, it appears to have remained relatively constant, since Genome-Wide Association Studies (GWASs) were first used in the 1990s. We find most variation to be across journals rather than within journals, suggesting that characteristics of journals are an important influence on the dissemination of research with diverse samples. Lack of racial diversity in genetic databases used to develop clinical applications could lead to disparities in the effectiveness of those applications for underrepresented groups.

Measuring the COVID-19 Financial Threat to Hospital Markets.

Many hospitals have been straining under the financial stress of treating COVID-19 patients. Those experiencing the greatest strain are in markets burdened with high levels of debt and uncompensated care. We propose a new measure of financial risk in a hospital market, combining both pre-existing financial vulnerability and COVID-19 severity. It reveals the highest concentrations of risk in counties with high poverty, low population density, and high shares of foreign-born and non-White populations. The CARES Act Provider Relief Fund helped many of the hospitals in these regions, but it left many markets with the same overall vulnerability to financial strain from the next health crisis.

Genetics and COVID-19: How to Protect the Susceptible.

Along with the potential for breakthroughs in care and prevention, the search for genetic mechanisms underlying the spread and severity of coronavirus disease 2019 (COVID-19) introduces the risk of discrimination against those found to have markers for susceptibility. We propose new legal protections to mitigate gaps in protections under existing laws.

Breaking down Silos to improve the health of older adults: The case for medicare to cover home safety renovations.

The ageing population is increasing the financial strain on the United States health care system, and society may be underinvesting in the place-based determinants of elderly health. The leading cause of injury for older Americans is falls in the home, resulting in more deaths than any other injury, as well as a significant portion of Medicare spending. While medical interventions have yielded mixed results, home safety renovations have been shown to be a cost-effective strategy to enable senior citizens to "age in place" safely, with the health care savings outweighing the upfront investment. Conservative projections demonstrate that Medicare can undertake this investment in home safety renovations with less than 2 percent of its budget, while breaking down the silos that unnecessarily encircle health and housing.