IHPI funds four policy-relevant projects focused on advancing health equity

The University of Michigan Institute for Healthcare Policy and Innovation (IHPI) announced today the awardees of its 2022 Policy Sprint initiative. Four IHPI member-led teams, chosen from many excellent proposals, will receive support for timely, policy-relevant projects that inform system-level solutions to advance health equity.

As addressing inequities in health care delivery and outcomes remains a critical issue, teams will develop projects that offer evidence-based solutions to inform ongoing decision-making at local, state, and national levels. Their projects will address gaps in knowledge of topics ranging from racial inequities in pain management and opioid use disorder treatment to abortion access to barriers to sickle cell disease care.

Thanks to generous donor support, each of the four teams will receive up to $10,000 in funding, as well as guidance from the IHPI policy engagement and communications staff. Renu Tipirneni, M.S., M.Sc., assistant professor of internal medicine, will also advise the project teams in her role as faculty advisor for IHPI Policy Engagement and External Relations.

Projects will begin immediately and conclude within the next three to six months. At the conclusion of their project, each team will produce a policy-relevant deliverable, such as an IHPI Policy Brief, one-pager, or infographic, to summarize research findings and key policy considerations. They will then work with the IHPI policy engagement team to share their work with policymakers and other relevant stakeholders.

The awarded Policy Sprint projects and principal investigators are:

• Communicated bias and its downstream effects on racial inequities in pain treatment in the emergency department 
  Project leads: Pooja Lagisetty, M.D., M.Sc., General Medicine, Medical School, and Christopher Fung, M.D., Emergency Medicine, Medical School
  Team: Martina Caldwell, M.D., Alexander Tsodikov, Ph.D., M.Sc., and David Jurgens, Ph.D.

  Numerous studies have demonstrated that Black patients experience disparities in pain treatment during emergency department (ED) visits, including being less likely to receive analgesia or opioids for pain relief compared to their White counterparts. To explore how health provider biases, such as pain-related stigma and racial discrimination, may be driving health inequities, Lagisetty and team will measure potentially stigmatizing language used in triage notes for patients presenting to the ED with pain-related concerns. They will then determine whether differences in triage note language are associated with differences in health outcomes by race and ethnicity.
   

• Racial and ethnic disparities in timely treatment initiation following emergency department visits for non-fatal opioid overdose 
  Project lead: Thuy Nguyen, Ph.D., M.P.A., Health Management and Policy, School of Public Health 
  Team: Kao-Ping Chua, M.D., Ph.D., Pooja Lagisetty, M.D., M.Sc., Amy Bohnert, Ph.D., M.H.S., and Yang Jiao, M.P.P.

  Despite a substantial rise in U.S. opioid overdose deaths in recent years, buprenorphine, a medication for opioid use disorder (OUD) that substantially decreases fatal overdose risk, remains widely underused, even after emergency department visits for opioid overdose. Moreover, little is known about buprepnorphine treatment among the 38% of low-income adults with OUD covered by Medicaid, a disproportionate share of whom are people of color. To address this knowledge gap, Nguyen and team will analyze racial and ethnic disparities in the receipt of buprenorphine among Medicaid enrollees to inform targeted interventions focused on improving equity of buprenorphine treatment.
   

• Impact of geography on abortion care access in Michigan
  Project lead: Lauren Owens, M.D., M.P.H.
  Team: Vanessa Dalton, M.D., M.P.H., Sarah Compton, Ph.D., M.P.H., Lauren Oshman, M.D., M.P.H., Rieham Owda, M.D., and Faelan Jacobson-Davies, M.S.

  In 2022, the U.S. Supreme Court will decide a case that could restrict abortion services established in Roe v. Wade. In this scenario, Michigan residents seeking abortion care may need to travel out of state. Owens and team will analyze data on the distance to abortion care by Michigan county, identify areas that are most likely to be affected by a ban, and examine whether distance to abortion care is associated with county-level maternal morbidity, racial composition, and socioeconomic status. Using the data, the team will create resources to inform policymakers about opportunities to address inequities in reproductive healthcare access across the state. 
   

• Leveraging population-based surveillance to identify individuals with sickle cell disease eligible for expanded benefits through Children’s Special Health Care Services
  U-M project lead: Sarah Reeves, Ph.D., M.P.H.
  U-M team: Kevin Dombkowski, Dr.P.H., Michaella Baker, M.S.W., and Krista Latta, M.P.H. 
  MDHHS partners: Dominic Smith, M.S.A., and Terra Depew

  Sickle cell disease (SCD), a group of disorders that cause lifelong issues with pain, stroke, and infection, affects over 100,000 Americans, most of whom are racial and ethnic minorities. Much of SCD’s morbidity can be avoided with preventive services, including daily medications and annual screenings, however, individuals with SCD frequently experience barriers to these services. To improve access to SCD care, Reeves and team, in partnership with the Michigan Department of Health and Human Services (MDHHS), will implement population-based surveillance to identify adults with SCD in Michigan who are now eligible to receive coverage for care due to a recent expansion of a state health services program.