Health Equity blog

A recent study published in Health Affairs reveals that Black, Hispanic, and Asian adults in the U.S. have significantly lower rates of engagement with each step of the “naloxone care cascade” compared to White adults. This cascade is a framework encompassing awareness, access, training, possession, and use of naloxone to counteract opioid overdoses. This research calls out a need for culturally tailored and equity-focused strategies that address the systemic causes of racial and ethnic disparities in naloxone engagement.

The California Dental Association (CDA) and its affiliated Foundation released their Health Equity Report in early September (announcement can be found here). The Report examines the challenges to oral health equity and suggests strategies to support recruitment and retention of dental professionals from underrepresented backgrounds. The goal is to reduce disparities in oral health outcomes by increasing the diversity of dental professionals who are more representative of California’s populace. The Report is in furtherance of the CDA’s and its Foundation’s 2022 policy aimed at “reinforcing its commitment to expanding care for underserved communities and improving diversity within the dental profession.”

The Mississippi State Department of Health (MSDH) declared a public health emergency (PHE) on August 21 in response to escalating infant mortality rates. Mississippi recorded 9.7 infant deaths per 1,000 births in 2024, the highest in over a decade. Declaring a PHE enables MSDH to mobilize resources more quickly and work with other agencies and organizations across the state to reverse the alarming trend. Efforts include eliminating “OB deserts” by increasing prenatal care opportunities utilizing targeted county health departments and expanding community health worker programs to connect mothers and babies with local care providers and other resources.

On August 27, the Centers for Disease Control and Prevention (CDC) authorized updated COVID-19 vaccine guidelines that limits the use of various COVID-19 vaccines for most age groups. The U.S. Food & Drug Administration (FDA) also revoked the Emergency Use Authorizations (EUAs) that made the Pfizer-BioNTech, Moderna, and Novavax COVID-19 vaccines available for children and younger adults without underlying health conditions. Although the newest version of the vaccines are authorized for all senior citizens, only younger adults and children with serious underlying health conditions are included in the new guidelines. In response, some health organizations, including the American Academy of Pediatrics, are issuing their own broader guidelines that differ from the CDC’s guidelines.

The American Medical Association (AMA), working with other organizations, has developed an online Mental Health Parity Index that is designed to evaluate commercial insurance plans based upon their coverage for, and access to, mental health/substance use disorder (SUD) services compared to medical services. This tool will facilitate more transparency into whether these plans have fulfilled the parity requirements established by the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). Earlier this year, the U.S. Department of Health & Human Services (HHS) announced a nonenforcement policy with regard to new regulations under MHPAEA that otherwise went into effect as early as January 2025, one of the purposes of which was to establish a “meaningful benefits” requirement for plans offering mental health/SUD services.

The U.S. Department of Health & Human Services (HHS) issued guidance, designed to enable more of the U.S. population to qualify for catastrophic health coverage through the Exchange based on need. Access will begin on November 1 during the start of open enrollment (the announcement can be found here and the Fact Sheet can be found here). These plans provide all essential health benefits required by the ACA but at lower premiums designed to increase financial accessibility. New this year will also be an online option for completing the hardship exemption request.

The One Big Beautiful Bill Act, signed into law on July 4, included a section that bars federal Medicaid funds from being “used to make payments” to a “prohibited entity” for items and services furnished during the year following enactment of the Act. The definition of “prohibited entity” is a non-profit entity that meets certain criteria including providing abortions (other than in the case or rape or incest or where the women’s life is in danger) and has received more than $800,000 in Medicaid reimbursements in 2023. Medicaid beneficiaries were barred from coverage with a health care provider that also provides abortion services. Although the bill did not specifically name Planned Parenthood, the narrowly defined provision is widely viewed as an attempt to defund Planned Parenthood. On July 28, a Federal District Court judge in Massachusetts issued a preliminary injunction that stops enforcement of the funding ban against Planned Parenthood and any affiliates. In issuing the order, the court reasoned that Planned Parenthood demonstrated a “substantial likelihood” that the legislation’s exclusionary language that was targeted at Planned Parenthood was unconstitutional and “threatens an increase in unintended pregnancies and attendant complications because of reduced access to effective contraceptives, and an increase in undiagnosed and untreated STIs.” The administration has appealed the ruling and also sought to stay the preliminary injunction pending the appeal.

In examining previously published research, the Kaiser Family Foundation issued a recent “data note” that analyzes if, and to what extent, immigrants contribute to the economy in U.S. rural areas. Although immigrant adults comprise only 5% of both the rural adult population and rural adult workforce, they hold a disproportionate share of certain occupations, such as agriculture workers (28%), physicians (14%), and construction workers (10%). Nonetheless, among them, noncitizen immigrant workers in rural areas are more likely to have lower incomes and be uninsured.

On July 24, President Trump issued an executive order addressing homelessness, particularly for such individuals afflicted with mental health complications or substance use disorders (SUD), by shifting federal policy toward involuntary civil commitment, public safety, and treatment-based interventions, and away from a top priority of trying to get people living on the streets into appropriate housing. The order also directs several federal departments, including the Department of Health and Human Services (HHS), to evaluate federal grant programs and prioritize funding for states and municipalities that actively crack down on unlawful drug use, urban camping and loitering, and urban squatting “to the maximum extent permitted by law.”

There have been several updates with litigation centered around gender affirming care. On August 1, sixteen states and D.C. filed a federal suit against the Trump administration for what the plaintiffs claim have been efforts to establish a “de facto” national ban on gender affirming care for adolescents. The plaintiffs’ complaint alleges numerous instances of concerted efforts, including criminal investigations and threatened prosecutions, by the Department of Justice (DOJ) and others arguably as a means by which to intimidate and instill fear among providers who might otherwise provide such services to their patients. Meanwhile, on August 6, the 10th Circuit Court of Appeals affirmed an Oklahoma Federal District Court’s decision denying the plaintiffs’ request to enjoin a state law that bans providers from providing gender affirming care to minors. Lastly, on August 8, several representative state prison transgender inmates filed a class action lawsuit in federal court against Georgia over a new law that bans them from receiving gender affirming care, claiming it is unconstitutional under the 8th Amendment’s prohibition of cruel and unusual punishment.