Worse Breast Cancer Outcomes for Black Women; NPs Pick Up Psychiatric Slack; and Buddhist Teachings and Depression

Patrick Lee

December 09, 2022

Worse Breast Cancer Outcomes for Black Women

Black women have worse breast cancer outcomes than do White, Asian, or Hispanic women, according to an in-depth analysis. American Black women have a 4% lower incidence of breast cancer but a 40% higher breast cancer mortality rate than do White women, according to a study presented at the San Antonio Breast Cancer Symposium 2022.

Five-year invasive disease-free survival was lower for Black women (87.2% vs more than 90% for the other racial groups), according to the new analysis of data from the RxPONDER trial. The trial was conducted in more than 4000 women with hormone receptor–positive and HER2-negative breast cancer and up to three positive lymph nodes. Similar results were seen when looking at distant relapse-free survival.

BMI effect: Adjustment for body mass index (BMI) appears to decrease the disparity. Black women were more likely to have high BMI than were women in the other groups.

The percentages: Some 27% of Black women participants had BMI of 30-34, and 35% had BMI higher than 35. That compares with 6% and 2% of Asian women, 21% and 18% of White women, and 22% and 16% of Hispanic women. BMI over 30 is considered obese.

NPs Pick Up Psychiatric Slack

Psychiatric mental health nurse practitioners (NPs) are filling the need created by a shortage of mental healthcare providers in the United States. The mental healthcare system relies more on such NPs to fill the gap for Medicare patients with mental health needs, according to a recent report in Health Affairs. The gap is due to psychiatrists who don't accept insurance, and fewer psychiatrists bill Medicare because of reimbursement cuts.

Prescribing meds: Such NPs can prescribe medication in many states, unlike psychologists and other therapists, and their services are less expensive than those of doctors.

Filling the gap: Psychiatric mental health NPs handled almost 1 in 3 psychiatric visits by Medicare patients from 2011 to 2019, the report finds.

Buddhist Teachings and Depression

Following five key Buddhist teachings may help protect against depression, new research shows. Rates of depressive symptoms were significantly lower among people who followed the Five Precepts of Buddhism compared with those who didn't, according to a study from Thailand, published in PLOS ONE. The Five Precepts are not to kill, steal, engage in sexual misconduct, tell ill-intentioned lies, or use intoxicants.

Unfamiliar precepts: The Five Precepts are not well known among international academics compared with mindfulness meditation, study authors note.

Depression buffer: The effect of neuroticism and perceived stress on depression may be buffered by positive variables such as self-efficacy, resilience, equanimity, and religious participation. Equanimity is a strength found in Buddhist discipline, the study says.

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