MARCH 2022
Director's Note
It’s Women’s History Month, which was established by Presidential proclamation since 1987 after being a week starting in 1980 under President Carter. IHPS has generated evidence to support policies to advance women for nearly 50 years, including a deep appreciation of the intersection between race and gender. Our current work includes a wide range of topics, including gender equity in academic medicine, reproductive health and abortion rights, Black perinatal equity, and breastfeeding policy and support. You’ll learn more about some of this work in this newsletter. And, we are gearing up for April 11-17, 2022, which was designated by President Biden and VP Harris as Black Maternal Health Awareness week – an area in which many of our faculty are actively shaping innovative solutions with the leadership of the communities we serve.

Joanne Spetz
IHPS Focus On:
Gender & Reproductive Health

Many IHPS faculty are working on policy related to gender and reproductive health. Valerie Flaherman, MD, MPH is one of the first researchers in the country to look at COVID-19 and pregnancy. Cynthia Harper, PhD is researching reproductive health access by community college students, including the impact COVID-19 has had. Sarah Garrett, PhD, is helping to provide evidence to help guide the local and state implementation of a new California law (SB464) to improve care for Black birthing people by reducing implicit bias. Both Jennifer Grandis, MD, and Christina Mangurian, MD, MAS, are looking at gender equity in academic medicine. Learn more about IHPS's current work in gender and reproductive health.

Upcoming Events
California Labor Lab Webinar Series
March 23, 2022
12 - 1 pm PT
Developments From the Bureau of Labor Statistics Household and Payroll Surveys

Patrick Carey
Department of Labor

Registration here
Learn more about the California Labor Lab, housed at IHPS, and the new seminar series here
IHPS "How to Impact Policy Change" Series
April 13, 2022
12 - 1 pm PT
How to Be a Resource to Journalists

Mollyann Brodie
Executive Vice President and COO
Kaiser Family Foundation

Webinar link here
Full Spring 2022 Webinar topics here
IHPS Health Policy Grand Rounds
April 20, 2022
12 - 1 pm PT
Emerging Evidence on the Impacts of Paid Family Leave on Workers, Families, and Employers

Maya Rossin-Slater, PhD,
Associate Professor, Health Policy
Stanford University, School of Medicine

Webinar link here
Save the Date!
UCSF Chancellor's Health Policy Lecture
May 3, 2022
4-5 pm PT
Genentech Hall, UCSF
Rethinking our approach to health after a pandemic: Lessons learned from Covid-19

Sandro Galea, MD, MPH, DrPH
Dean and Robert A. Knox Professor
Boston University School of Public Health
Research Highlights

In a recent Journal of the American College of Radiology article, Rebecca Smith-Bindman, MD and colleagues describe strategies used by health care organizations in the United States, Europe, and Japan to optimize CT dose imaging. Five of the strategies are related to the change process capability of an organization, including engaging radiologists and technologists, establishing a CT dose committee, managing organizational change, providing leadership support, and monitoring and benchmarking. Two strategies focused on care process structures within the organization, including modify CT protocols and facilitating equipment and work rule changes. Taken together, these seven strategies present a potential framework for health care organizations to consider as they navigate the complex challenge of optimizing CT dose and make meaningful and sustained improvement in the care and safety of patients receiving medical imaging.

The landscape of payment for genetic testing has been changing, with an increase in the number of laboratories offering testing, larger panel offerings, and lower prices. In a recent article in The Journal of Genetic Counseling, Grace Lin, MD and Kathryn Phillips, PhD, along with their colleagues, found that using laboratories with payment assistance programs reduces barriers to next-generation sequencing (NGS) panel testing for genetic cancers among diverse populations. Such programs represent a major change to the financing and affordability of genetic testing. However, access to genetic counseling is a barrier and must be addressed to ensure equity in testing.

Drawing on evidence of socioeconomic disparities in emergency care, Renee Hsia, MD, MSc and colleagues show how structural discrimination is the most pervasive driver of these disparities, largely because of an inequitable distribution of healthcare services and unequal benefits derived from scientific advancement in a recent Med article. Hsia and colleagues analyze how the market-based healthcare system in the US has created a scenario in which the allocation of emergency care resources does not match community demand for emergency care, resulting in disproportionately poor access, treatment, and outcomes among historically underserved populations. Rather than letting a drive for profit dictate the expansion of emergency care, health authorities should use unbiased and nuanced metrics to inform regulation of the emergency care system and implement systems to monitor whether these initiatives realize their intended effects and do not unintentionally exacerbate existing disparities. By addressing structural inequities in emergency care, we can help heal the system for us all.

IHPS faculty are responding to policy challenges raised by the
COVID-19 pandemic with rapid-cycle research and technical assistance. A compilation of their work to date is available on a regularly updated webpage. 

One recent publication is by Elan Guterman, MD, Addressing Vulnerability and Dementia in the Era of COVID-19 published in JAMA Neurology.  Read more about our work to address the COVID pandemic here.
IHPS Faculty Spotlight
Lena Winestone, MD, is an assistant professor in the Department of Pediatrics and affiliated faculty at the Philip R. Lee Institute for Health Policy Studies. Her research explores racial, ethnic, and socioeconomic disparities in access to care and outcome of leukemia and lymphoma treatment. Dr. Winestone studies access to care across the continuum of pediatric cancer from diagnosis and clinical trial enrollment through treatment and relapse to salvage therapies. Her research has shown that African American children with acute lymphoblastic leukemia, acute myeloid leukemia, and mature B cell lymphoma are two times more likely to present with organ failure at the time of a new cancer diagnosis. Dr. Winestone's ongoing work investigates access to highly specialized and complex therapies such as stem cell transplant, chimeric antigen receptor T cells, and MIBG therapy.
Media Mentions