Author Interviews, COVID -19 Coronavirus, UCLA / 20.03.2021

MedicalResearch.com Interview with: Richard K. Leuchter, MD Resident Physician Department of Internal Medicine UCLA Health MedicalResearch.com: What is the background for this study? Response: There has been significant research demonstrating racial healthcare disparities among patients with COVID-19, but less exploring how the COVID-19 pandemic has affected the healthcare of racial & ethnic minority groups without COVID-19. It is important to understand the ways in which the pandemic has exacerbated the inequitable delivery of healthcare in order to design policies to address these racial injustices. We focused on potentially avoidable hospitalizations, which are admissions to a hospital (not for COVID-19) that likely could have been prevented through timely and high-quality outpatient care. Prior research has shown that avoidable hospitalizations are markers for access to outpatient care, and expose patients to preventable financial burden, separate them from their families, and put them at risk for hospital-acquired infections. (more…)
Author Interviews, Autism, JAMA, Mental Health Research, Pediatrics, Race/Ethnic Diversity / 08.03.2021

MedicalResearch.com Interview with: Dr. Kevin Lu PhD Clinical Pharmacy and Outcomes Sciences College of Pharmacy Medical University of South Carolina MedicalResearch.com: What is the background for this study?  Response: It is documented that the prevalence of autism spectrum disorder (ASD) has been increasing in the past few years. However, no information on potential racial and ethnic disparities in ASD diagnosis can be found in the literature. Most recently, the possible structural racism and health inequities have been a concern for the public and policy makers. (more…)
Author Interviews, Cancer Research, Hepatitis - Liver Disease, Race/Ethnic Diversity / 25.02.2021

MedicalResearch.com Interview with: Andrea D. Branch PhD Professor of Medicine Division of Liver Diseases Associate Professor of Surgery Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Liver cancer is a deadly condition with a high mortality rate. About 90% of people who develop liver cancer have cirrhosis (advanced liver scarring) due to a chronic underlying liver disease. Patients with cirrhosis are advised to undergo liver cancer surveillance. Early detection improves survival, but diagnosis requires more than a blood test, which makes surveillance complex and expensive. Black individuals are more likely to develop liver cancer than white individuals and are more likely to die from it. Black patients also have more advanced liver cancer at the time of diagnosis than Whites. We aimed to identify additional factors that distinguish liver cancer in African Americans, focusing on patients with hepatitis C virus infection, the most common chronic liver disease in people who die from liver cancer in the United States. (more…)
Author Interviews, COVID -19 Coronavirus, Education, Race/Ethnic Diversity, Social Issues / 04.02.2021

MedicalResearch.com Interview with: Ankur Dalsania Rutgers New Jersey Medical School (NJMS) M.D. Candidate 2021 MedicalResearch.com: What is the background for this study? Response: Similar to past pandemics, prior studies and news articles have highlighted the disproportionate impact of COVID-19 mortality in marginalized populations, especially Black Americans. Rather than biological differences, other factors like neighborhood conditions, educational attainment, economic stability, healthcare access, and social contexts have been hypothesized to influence the racial disparities. Using county-level data, we sought to quantitatively determine how these factors, collectively referred to as social determinants of health, impact COVID-19 mortality in Black Americans.  (more…)
Author Interviews, Breast Cancer, Genetic Research, JAMA, Race/Ethnic Diversity / 22.01.2021

MedicalResearch.com Interview with: Kent Hoskins, MD Eileen Lindsay Heidrick Professor in Oncology Division of Hematology/Oncology University of Illinois at Chicago Director of Cancer Genetics Co-Leader, Breast Cancer Research Group University of Illinois Cancer Center MedicalResearch.com: What is the background for this study? Response: The racial disparity in breast cancer mortality emerged in the US in the late 1980s in the wake of widespread implementation of mammography screening and the development of successful systemic adjuvant therapies for early breast cancer. Unfortunately, more than three decades later, Black women in the US still have a 40% higher mortality rate from breast cancer compared with non-Hispanic White women despite similar disease incidence. Health disparities research has primarily focused on the fact that Black women have a higher incidence of the aggressive triple-negative subtype, and that they are more likely to present with more advanced stages of disease. As important as those factors are, in recent years our group and others reported that Black women with hormone receptor-positive breast cancer have worse survival than non-Hispanic white women even after adjustment for stage at diagnosis and treatment. Since nearly 2/3 of breast cancers in Black women are hormone receptor-positive, this is a significant contributor to the overall mortality disparity. Importantly, these studies also suggested that Black women disproportionately develop biologically aggressive forms of hormone-dependent breast cancer, which is typically considered a more favorable disease subtype. Using data on more than 70,000 patients from the SEER registry that is linked to data from Genomic Health Laboratory, which provides the Oncotype DX recurrence score (the most commonly ordered prognostic/predictive multi-gene expression assay for early breast cancer), we set out to address three questions: 1) is there evidence of disproportionately aggressive tumor biology among Black women with hormone receptor (HR)-positive breast cancer, as reflected in the Oncotype DX recurrence score? 2) Is there a racial survival disparity even among patients with early stage, axillary node-negative tumors with comparable recurrence scores on the Oncotype assay? and 3) Is there is a difference in the prognostic accuracy of the Oncotype assay between Black and non-Hispanic white patients, since there was limited representation of Black women in the development and validation of the Oncotype assay and other prognostic/predictive assays?  (more…)
Author Interviews, COVID -19 Coronavirus, Mental Health Research, Race/Ethnic Diversity, Social Issues, UCSF / 15.01.2021

MedicalResearch.com Interview with: Jason Nagata, MD, MSc Assistant Professor of Pediatrics University of California, San Francisco San Francisco, California MedicalResearch.com: What is the background for this study? Response: Food insecurity is the inability to afford or access nutritionally adequate and safe foods for an active, healthy lifestyle. Rates of food insecurity were projected to rise during the COVID-19 pandemic; however, prior studies had not examined the association between food insufficiency, the most extreme form of food insecurity, and mental health. MedicalResearch.com: What are the main findings? Response: Using a large national sample of nearly 64,000 adults, we found that food insufficiency rose from 8.1% to 10.0% during the pandemic. People of color and younger adults had higher risk of food insufficiency. People living in poverty or experiencing recent job loss were at higher risk of food insufficiency. Food insufficiency was associated with symptoms of anxiety, worrying, and depression. Hunger, exhaustion, and worrying about not getting enough food to eat may worsen depression and anxiety symptoms. Receiving food assistance alleviated the relationship between food insufficiency and poor mental health.   (more…)
Author Interviews, COVID -19 Coronavirus, Infections, JAMA, NYU, Race/Ethnic Diversity / 04.12.2020

MedicalResearch.com Interview with: Gbenga Ogedegbe, MD, MPH Dr. Adolph & Margaret Berger Professor of Population Health Director, Division of Health & Behavior Director Center for Healthful Behavior Change Department of Population Health NYU Langone Health NYU School of Medicine MedicalResearch.com: What is the background for this study? Response: The background for the study is the disproportionately higher rates of COVID-19 hospitalizations and deaths in Blacks and Hispanics compared to Whites in major cities across the country. We asked two questions: 1) are there racial/ethnic differences in COVID-19 outcomes (likelihood of testing positive, hospitalizations, severe illness, and deaths) among patients who receive care at NYU Langone Health? If there are differences, are they explained by comorbidity and neighborhood characteristics (poverty, educational status, employment, housing, proportion of Blacks and Hispanics in communities)? (more…)
Author Interviews, JAMA, Social Issues / 04.12.2020

MedicalResearch.com Interview with: Amal Trivedi, MD, MPH Professor of Health Services, Policy & Practice Director of Graduate Studies, Health Services Research Brown University School of Public Health MedicalResearch.com: What is the background for this study? Response: Nearly all hospitals in the United States, including all Veterans Affairs Medical Centers (VAMCs), report mortality rates for patients hospitalized for common medical and surgical conditions. But these mortality rates do not adjust for socioeconomic factors that are associated with worse outcomes following hospitalization. (more…)
Accidents & Violence, Author Interviews, Pediatrics, Race/Ethnic Diversity / 26.11.2020

MedicalResearch.com Interview with: Dr. Monika K. Goyal, MD Associate Division Chief, Emergency Medicine Children’s National Hospital Department of Pediatrics, School of Medicine and Health Sciences The George Washington University Washington, District of Columbia MedicalResearch.com: What is the background for this study? Response: There has been growing attention to the disproportionate use of police force in communities of color. Therefore, we sought to investigate whether Black and Hispanic teenagers have higher rates of death due to police shootings when compared to white youth. (more…)
AHA Journals, Author Interviews, COVID -19 Coronavirus, Race/Ethnic Diversity, Stanford / 19.11.2020

MedicalResearch.com Interview with: Fatima Rodriguez, MD, MPH, FACC, FAHA Assistant Professor, Cardiovascular Medicine Stanford University School of Medicine Palo Alto, CA 94304 MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has magnified existing racial/ethnic disparities in the United States. The goal of this study was to leverage new data collected from the American Heart Association’s COVID-19 Cardiovascular Disease Registry to understand racial/ethnic differences in presentation and outcomes for hospitalized patients. (more…)
Author Interviews, Cannabis, Ophthalmology, Race/Ethnic Diversity, Social Issues / 09.11.2020

MedicalResearch.com Interview with: Joshua Uhr MD Ophthalmologist Philadelphia, PA MedicalResearch.com: What is the background for this study? Response: Disparities in American society have been at the forefront of the public consciousness in recent months. As part of the larger discussion about inequality, disparities in health outcomes have received much attention. In light of the renewed recognition that these disparities are stark and widespread, we felt it important to evaluate disparities in our own field, ophthalmology. Previous studies have shown disparate outcomes for individual eye conditions, such as glaucoma, cataract, and retinal detachment. Although the common and relevant endpoint of these is visual impairment, few prior studies have examined disparities in visual impairment more broadly. Our aim was to provide an updated analysis of disparity in visual impairment among adults in the United States based on race and socioeconomic status.  (more…)
Author Interviews, COVID -19 Coronavirus, Race/Ethnic Diversity, Rheumatology, UCSF / 07.11.2020

MedicalResearch.com Interview with: Milena Gianfrancesco, PhD, MPH Assistant Professor. Education Division of Rheumatology, Department of Medicine University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: This study utilized data from the COVID-19 Global Rheumatology Alliance Provider Survey, which launched on March 25th. To date, it has collected information on over 6,000 patients with rheumatic disease diagnosed with COVID-19 from over 40 countries worldwide. As COVID-19 spread across the world in the spring, and especially within the United States, it became clear that the disease was impacting certain groups more than others. Growing attention and research began to illustrate the disproportionate burden of COVID-19 among racial/ethnic minorities in the United States. We know that racial and ethnic minorities experience a higher burden of rheumatic disease risk and severity; therefore, our group was interested in examining whether the disproportionate burden of COVID-19 also affected this susceptible population. (more…)
Accidents & Violence, Author Interviews, Race/Ethnic Diversity / 21.08.2020

MedicalResearch.com Interview with: Ashwini Sehgal, MD Professor, Department of Medicine, School of Medicine Professor, Department of Bioethics, School of Medicine Professor, Department of Population and Quantitative Health Sciences, School of Medicine Director and Duncan Neuhauser Professor of Community Health Improvement, Center for Reducing Health Disparities, Case Western School of Medicine  MedicalResearch.com: What is the background for this study? Response: News media and politicians frequently discuss the high toll of deaths from firearms and drug overdoses. They usually mention the numbers of deaths, citing figures like 40,000 firearm deaths last year, or death rates such as 20 overdose deaths per 100,000 population. But for most people, it's hard to grasp the real meaning of both the large absolute numbers and the small annual rates.  So in a new study published in the American Journal of Medicine, I used official death certificate data to calculate the chance that an American child will die from a gunshot or a drug overdose over the course of a lifetime. (more…)
Author Interviews, Pediatrics, Race/Ethnic Diversity / 19.08.2020

MedicalResearch.com Interview with: Anura Ratnasiri PhD Senior Research Scientist (Epidemiology and Biostatistics) Benefits Division Department of Health Care Services Sacramento, CA 95899-7417 MedicalResearch.com: What is the background for this study? Response: Infant mortality rate (IMR) is a widely-reported indicator of population health and is used as a standardized measurement of deaths in the first year of life per thousand live births. While IMR has been steadily declining in the United States, it remains relatively high compared with other developed countries. Even though significant improvements have been made in the quality and access to neonatal and infant care during the past decade, large educational, socioeconomic, racial, ethnic, geographic and behavioral disparities persist, and appear to be responsible for significant differences in IMR among different subgroups. Certain maternal and infant characteristics have important associations with IMR, and this study attempted to quantify major maternal and infant predictors, and trace associated mortality trends during the study period. There were no recent studies on infant mortality using a large data set such as California State. Moreover, gestational age based on obstetric estimates from fetal ultrasound, prepregnancy obesity, and smoking during pregnancy were not available in prior population-based studies in California. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Race/Ethnic Diversity / 17.08.2020

MedicalResearch.com Interview with: Pinar Karaca-Mandic, PhD Professor, Finance Department Arthur Williams Jr. Professor of Healthcare Risk Management Academic Director, Medical Industry Leadership Institute (MILI) Carlson School of Management University of Minnesota MedicalResearch.com: What is the background for this study? Response: Several studies have highlighted disparities in COVID-19 infection rates and deaths. Less is known about disparities in hospitalizations. Reports from the Centers for Disease Control showed that in the nation overall, non-Hispanic Blacks, Hispanics and American Indian Alaska Native persons have substantially higher rates of COVID-19 hospitalization. Our study extends this work by providing a state-by-state analysis of race/ethnic prevalence of cumulative COVID-19 hospitalizations and comparing this prevalence to ethnic/racial composition of each state’s population. Through our University of Minnesota Covid-19 hospitalization tracking project (https://carlsonschool.umn.edu/mili-misrc-covid19-tracking-project) we collect data every day from state department of health websites, and we started collecting information on race/ethnicity breakdown of the hospitalizations as soon as states started reporting such data. During our study period, between April 30 and June 24, 12 states reported cumulative hospitalizations by race/ethnicity. By the end of our study, our data from these 12 states represented almost 50,000 hospitalizations.  (more…)
Author Interviews, JAMA, Race/Ethnic Diversity, Social Issues / 03.08.2020

MedicalResearch.com Interview with: Nasim B. Ferdows, Ph.D. Assistant Professor, Department of Health Administration and Policy Hudson College of Public Health The University of Oklahoma Health Sciences Center Oklahoma City, OK MedicalResearch.com: What is the background for this study? Response: This half a century study of US senior men and women who died between 1968 and 2016 shows how disparities in the Black and White mortality of older US citizens have changed over time, as well as how the racial disparities differ in rural, suburban and urban areas. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics / 11.06.2020

MedicalResearch.com Interview with: Colm Travers, M.D., MSPH Assistant Professor Department of Pediatrics University of Alabama at Birmingham MedicalResearch.com: What is the background for this study? Response: It is known that black mothers are much more likely to deliver preterm and low birth weight infants. The purpose of this study was to determine whether racial/ethnic disparities in care practices and outcomes were decreasing or increasing among extremely preterm infants. These are infants born from 22 to 27 weeks of gestation who have a high risk of death and major illnesses.  (more…)
Author Interviews, COVID -19 Coronavirus, Race/Ethnic Diversity / 21.05.2020

MedicalResearch.com Interview with: Charles H. Hennekens, MD, DrPH Sir Richard Doll Professor Senior Academic Advisor FAU, Boca Raton, FL  MedicalResearch.com: What is the background for this study? Response: Blacks and other disadvantaged minorities in the United States have markedly reduced life expectancies compared with their white counterparts.  As is the case with most fatal diseases, coronavirus disease (COVID-19) is already taking a disproportionate toll on blacks and other disadvantaged minorities. (more…)
Author Interviews, JAMA, Orthopedics, Race/Ethnic Diversity, Surgical Research / 19.05.2020

MedicalResearch.com Interview with: Alyson Cavanaugh, PT, PhD Joint Doctoral Program in Epidemiology University of California, San Diego/ San Diego State University MedicalResearch.com: What is the background for this study? Response: More than 700,000 total knee replacements are performed annually in the United States, but there is a racial disparity in outcomes after the surgery. If the knee replacement procedure is considered a highly effective treatment, why don't black women present with the same outcomes as whites? Physical function when going into surgery has a large impact on the potential functional outcomes after surgery. Our hypothesis was that black women were presenting to surgery with poorer physical function, which was contributing to poorer functional outcomes after surgery. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Heart Disease, Race/Ethnic Diversity, Statins / 14.05.2020

MedicalResearch.com Interview with: Dr. Ankur Pandya, PhD Assistant Professor of Health Decision Science Department of Health Policy and Management Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: The 2013 ACC-AHA cholesterol treatment guidelines greatly expanded statin medication eligibility for individuals between the ages of 40-75 years without known cardiovascular disease, and there was some concern that African Americans at "intermediate risk" per those guidelines could be (arguably) overtreated with statins. The 2018 ACC-AHA guidelines included coronary artery calcium assessment for individuals at intermediate cardiovascular disease risk; those with a "zero" calcium score and no other risk factors would now change the eligibility (from indicated statin to not indicated). (more…)
Author Interviews, Dermatology, Melanoma / 08.05.2020

MedicalResearch.com Interview with: Neelam A. Vashi, MD Associate Professor of Dermatology Director, Boston University Center for Ethnic Skin Director, Cosmetic and Laser Center Boston University School of Medicine and Daniela P.Sanchez BS Boston Medical Center Boston, MA 02118 MedicalResearch.com: What is the background for this study? Response: Although melanoma most commonly affects Caucasians, Hispanics are disproportionately affected by greater morbidity and mortality rates when diagnosed. Poor prognosis in Hispanic patients is likely multifactorial, and may be secondary to lack of knowledge or misconceptions about melanoma risk, atypical presentation, impaired access to care, and language barriers, ultimately resulting in a delay in diagnosis. (more…)
Author Interviews, Beth Israel Deaconess, COVID -19 Coronavirus, JAMA, Race/Ethnic Diversity / 01.05.2020

MedicalResearch.com Interview with: Rishi Wadhera, MD, MPP, MPhil Instructor in Medicine at Harvard Medical School Cardiologist,Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: With more than a million confirmed cases of COVID-19 in the United States, there is growing concern that low-income communities and racial/ethnic minorities may be disproportionately shouldering the burden of the pandemic. New York City, which is comprised of 5 boroughs (Bronx, Brooklyn, Manhattan, Queens, and Staten Island) with unique demographic and socioeconomic characteristics, has emerged as the epicenter of the COVID-19 outbreak. (more…)
Author Interviews, Breast Cancer, Cost of Health Care, JAMA, Race/Ethnic Diversity / 09.01.2020

MedicalResearch.com Interview with: Naomi Y Ko, MD Director, Inpatient Medical Operations Assistant Professor of Medicine, Department of Medicine Boston University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is to help understand the association between risk of more advanced cancer in racial minorities and insurance.   (more…)
Author Interviews, Education, JAMA, Race/Ethnic Diversity, Social Issues / 02.12.2019

MedicalResearch.com Interview with: Lynn Blewett, PhD Mayo Professor, Division of Health Policy and Management Director, State Health Access Data Assistance Center (SHADAC) University of Minnesota MedicalResearch.com: What is the background for this study? Response: We used a new set of questions about patient's perspectives of cultural competence of their providers that was added to the National Health Interview Survey and accessed through the Minnesota Population Center IPUMS Health Surveys.   MedicalResearch.com: What should readers take away from your report? Response: Most patients (97%) report being treated with respect by their providers. BUT we also found important disparities.  Black or Hispanic (vs White), uninsured (vs insured), and low income (vs >200% FPL) individuals reported being treated with respect less often, viewed a shared culture as more important, and saw providers who shared culture less often. (more…)
Author Interviews, Cancer Research, Gender Differences, JAMA / 02.11.2019

MedicalResearch.com Interview with: Nina Niu Sanford, M.D. Assistant Professor Dedman Family Scholar in Clinical Care UT Southwestern Department of Radiation Oncology Dallas TX MedicalResearch.com: What is the background for this study? Response: Minority racial/ethnic groups present at later stages of cancer and have worse stage-specific survival rates.  Cultural competency represents a single element within the dynamic and trans-disciplinary field of health disparities, but is an important modifiable factor for both providers and health organizations that could be associated with disparities in cancer outcomes. There have been longstanding initiatives and training requirements in medical education specifically designed to improve provider cultural competency over the past couple of decades, and the American Society of Clinical Oncology (ASCO) has recently outlined goals for improving cultural competency within its policy statement on cancer disparities. Moreover, ASCO health disparity policies have recently highlighted the association between racial/ethnic disparities in cancer outcomes and a “lack of access to high-quality care that is understanding and respectful of diverse traditions and cultures plays a significant role.”  Given the above, we wished to assess access to culturally competent providers among patients with cancer by race/ethnicity. (more…)
Author Interviews, Heart Disease, Race/Ethnic Diversity / 30.10.2019

MedicalResearch.com Interview with: Michelle Morse, MD, MPH Founding Co-Director, EqualHealth Soros Equality Fellow Assistant Professor, Harvard Medical School Co-Founder, Social Medicine Consortium  MedicalResearch.com: What is the background for this study?
  • Response: Frontline clinicians have a unique vantage point to identify and characterize inequities in care. This study was inspired by internal medicine residents’ first-hand clinical experiences of black and Latinx patients who were frequently admitted to the general medicine service, as opposed to the cardiology service, with an ultimate diagnosis of HF.
  • Research has shown that structural inequities are pervasive throughout healthcare delivery systems and across many services, within both the inpatient and outpatient arenas. We hope other institutions and clinicians will be equally committed to addressing inequities in their own contexts, systems, and care settings and that patients will identify opportunities for self-advocacy in their care.
(more…)
Author Interviews, Emergency Care, JAMA, Race/Ethnic Diversity / 09.09.2019

MedicalResearch.com Interview with: Amresh D Hanchate, PhD Research Assistant Professor Department of Medicine, School of Medicine Boston University MedicalResearch.com: What is the background for this study? Response: National guidelines require EMS transportation to the nearest suitable hospital. To what extent this occurs and whether this varies by the race and ethnicity of the patient is unknown since there is little to no prior research on destination patterns of EMS-transported patients to hospitals. (more…)
Author Interviews, JAMA, NIH, Race/Ethnic Diversity / 25.07.2019

MedicalResearch.com Interview with: Lan N. Đoàn, MPH CPH PhD Candidate, School of Social and Behavioral Health Sciences College of College of Public Health and Human Sciences Oregon State University, Corvallis MedicalResearch.com: What is the background for this study? Response: There is a prevailing stereotype that Asian American, Native Hawaiian, and Pacific Islander (AA/NHPI) populations are a model minority group - healthier than all other racial/ethnic groups. As a result, health researchers often consider AA/NHPI so similar that their data is typically grouped together which masks their cultural and health differences. However, AA/NHPI populations represent more than 50 countries or cultures of origin and 100 different languages and have unique health needs and cultural preferences. Prior research has found minimal financial investments in AA/NHPI populations by federal agencies and philanthropy, even though AA/NHPI individuals represent more than 5.0% of the total US population and are the fastest-growing racial/ethnic group in the United States. The purpose of study was to conduct a review of clinical research funded by the National Institutes of Health (NIH) for AA/NHPI populations and to determine the level of NIH investment in serving these populations. We queried the NIH Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) system for extramural AA/NHPI focused clinical research projects conducted in the United States from January 1, 1992, to December 31, 2018. We included clinical research funded under research project grants, centers, cooperative awards, research career awards, training grants, and fellowships was included, with an advanced text search for AA/NHPI countries and cultures of origin.  (more…)
Author Interviews, CDC, OBGYNE, Race/Ethnic Diversity / 17.05.2019

MedicalResearch.com Interview with: Emily Petersen, MD. Lead for the Pregnancy Mortality Surveillance System Division of Reproductive Health   MedicalResearch.com: What is the background for this study? Response: About 700 women die of pregnancy-related causes each year in the United States. The new analysis provides much-needed perspective on the circumstances surrounding pregnancy-related deaths and summarizes potential strategies to prevent future deaths. (more…)