The Scan by 2 Minute Medicine®: Endometriosis Awareness Month, OnlineMedEd Charges, Canadian Grocery Store Controversy, BetterHelp’s Privacy Concerns

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Endometriosis Awareness Month

The Story: March is known as Endometriosis Awareness Month, which brings attention to the condition that affects roughly 1 in 10 women of reproductive age around the world. Bindi Irwin, an Australian television personality, recently shared her struggles with endometriosis on International Women’s Day. Irwin isn’t the first celebrity to go public about their battle with endometriosis: Sarah Hyland, Chrissy Teigen, and Halsey are just a few notable names amongst the approximately 190 million women worldwide who are affected by the condition.

 What is Endometriosis?

Endometriosis is a condition affecting women of reproductive age, when tissue that normally lines the uterus, the endometrium, is found elsewhere, such as the fallopian tubes and ovaries. The most common symptom associated with endometriosis is pain– pelvic pain, painful periods, and pain during intercourse. However, heavy menstrual cycles, fatigue, nausea, and infertility are some of the other symptoms that patients face. Treatments such as hormonal therapies, surgical removal of the aberrant tissue, pain management, and in severe cases, hysterectomy, can help relieve symptoms. The effects of endometriosis remain a significant burden to the individuals affected, as well as to the economy and healthcare system. The condition has been known to negatively affect mental health, sexual satisfaction, and social relationships in those affected. Furthermore, patients with endometriosis have been known to experience multiple comorbidities, and recently it was found that patients with the condition had an increased risk of cardiovascular events than those without. Meanwhile, the costs of care for endometriosis have been reported at anywhere from $1,000 to upwards of $20,000 per patient per year, while the annual indirect costs per patient, such as productivity loss, are estimated to be anywhere from approximately $4,500 to $14,000.

The Issue of Diagnosis

Despite the vast prevalence of the conditions, and the painful symptoms associated, the diagnosis of endometriosis is often delayed. In fact, studies have reported that the average diagnostic delay of endometriosis is over 6 years. This means that individuals are living with the disease, unmanaged, for many years before receiving adequate treatment. One of the factors leading to delays and misdiagnoses, is the wide spectrum of symptoms that the condition can cause, often leading to misdiagnosis with another chronic condition. Another issue is that laparoscopy, an invasive surgical procedure, is the gold standard for the diagnosis of endometriosis. Meanwhile, limited research into the condition and stigma has also played a role. The delay in diagnosis associated with endometriosis is one of many issues that have been pointed out when discussing the gender health gap: the issue of poorer health outcomes in women than in men.

Online MedEd Charges, 

OnlineMedEd, previously a free online resource for medical students and trainees, is adding a paywall to their content. The educational content will now cost anywhere from $65 a month to over $400 a year to access. The news is shedding light on financial barriers in medicine, and the cost of outside resources to support learning and licensing exams. The cost of medical school in the US is estimated at anywhere between $39,000 to over $60,000 per year. The AAMC estimates that the average debt of graduating medical students is over $200,000. These costs aren’t limited to just tuition, but also living costs, writing exams, external resources, and more.

Cost can be a considerable barrier to those entering the field of medicine. It is likely why individuals of lower socioeconomic status are underrepresented in the field. A study of medical students at the University of Michigan found that race, first-generation college student status, household income, and parental education were all factors that were associated with higher levels of debt in medical school. Debt and financial constraints are not only barriers to entering medicine but are also barriers to success once in the field, as it’s been found that financial stresses and debt can negatively impact student well-being, and academic outcomes. Clearly, the financial burden of medical school is a barrier for prospective students, and a stressor to current trainees. Many are looking for unique solutions to address these issues by reducing the financial strain on current and future trainees. Some schools, such as NYU,  are trying to address these issues by moving to tuition-free models to ensure equitable access to medical education. Diversifying the medical system and making sure the field is accessible to all will certainly require innovative solutions to the financial barriers that exist in the field.

Canadian Grocery Store Controversy

Canada’s largest grocery store chain is under scrutiny for what many are accusing of “greedflation”: raising prices more than what is required by inflation. While Loblaws is reporting record earnings, Canadians aren’t feeling the same success. In fact, as a result of rising food prices and economic strain, foodbank usage is expected to increase by 60% in Canada this year. The role that grocery store prices play in food insecurity is being highlighted as a result.

A person is said to experience food insecurity when they lack regular and reliable access to nutritious food, which can impact their ability to lead a healthy life. Estimates suggest that over 5 million Canadians, and over 34 million Americans are food insecure. A lack of reliable access to safe and healthy food has several impacts on health outcomes. For example, food insecurity has been associated with obesity, diabetes, heart disease, poor mental health, and more. This can also have a significant impact on growth and development, so the fact that 9 million children in the United States are experiencing food insecurity is of great concern. In fact, studies have found that experiencing food insecurity in childhood can lead to poor health and worse functioning in adolescence. Addressing issues of food access in children, through things such as food hardship relief and nutritional programs have been shown to improve health outcomes in children and reduce pediatric emergency room visits. Tackling rising grocery store prices will not only reduce financial strain on families but will also help to improve health outcomes for all.

BetterHelp’s Privacy Concerns

BetterHelp is facing backlash and charges for sharing personal information about its clients with marketing companies. The mental health service touts itself as the largest online counseling platform in the world, making these services more accessible for people. However, the company is now being hit with a $7.8 million fine for data misuse after they were found to share private information with advertising services. Many are questioning if the recent news will impact the usage of other online mental health services.

Many mental health apps and online services have proven to be successful in reducing the burden of mental illness in affected individuals. These online services also reduce financial barriers, given that services such as in-person therapy tend to cost over $100 per session. For these reasons, the usage of mental health apps has been on the rise, particularly during the COVID-19 pandemic. However, a rise in the users has also resulted in a significant increase in the number of online services, with estimates of the number of mental health apps on the market currently at around 20,000. Quantity doesn’t always mean quality though, and there are concerns that the sheer number of apps on the market is drawing attention away from those that have actually proven effective. Making mental health services accessible is important for the estimated 1 in 5 Americans who experience mental illness each year, and online resources play a part in achieving this goal. However, concerns about the quality of these many apps, the claims made by the producers, and now issues of data sharing and misuse remain important barriers to the successful implementation of these services.

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