Three pieces last week run on a primitive that took me a while to see: when policy gets written about disparate harm, the data underneath the policy is often missing the direction of the disparity. The FDA approved a non-antipsychotic for Alzheimer-related agitation on April 30. The standard reframe is "this protects Black patients from being overprescribed antipsychotics." The five US Medicare studies our reporter built the piece around say the opposite: Black patients living with dementia are underdiagnosed for behavioral and psychological symptoms and undertreated with CNS-active drugs. The UK overprescribing pattern does not generalize. The reframe is not "more nonmedication-first," it is "make sure the diagnosis happens at all."
That is one of three reports we ran this week. Each one starts where the population-level data starts and stops where Black-specific evidence stops.
1. Auvelity for Alzheimer-related agitation: the under-treatment direction
The piece walks through the April 30 FDA approval, the three US Medicare studies showing Black dementia patients are underdiagnosed for BPSD, and the structural-access constraint that determines whether a Black family caregiver can actually get the new drug for their parent. The reader-action close names three concrete moves: ask the prescriber whether BPSD has been assessed at all, ask whether non-antipsychotic options including Auvelity are on the table, and use our directory if you need a Black-clinician second opinion. Our evidence memo cites Cataife 2015, Saloner 2013, and Bushnell 2023 as the trio that documents the under-treatment direction. The piece links each citation in the body.
2. The Illinois doula correction-2: Mbande, Taylor, and the 78-per-100,000 figure
The piece evaluates Illinois's January 2026 dual-track Medicaid + private-insurance doula mandate, four months in. Bohren 2017 Cochrane review (27 trials, 15,858 women, 25 percent cesarean reduction) is the load-bearing evidence anchor. Mosley 2023 reimbursement-constraint argument frames the binding constraint. Three named doulas in the body: Tayo Mbande and Toni Taylor at Chicago Birthworks Collective, plus the Block Club Chicago reporting. IDPH data: 78 deaths per 100,000 live births for Black women in Illinois vs 25 overall. Our reporting names the implementation question (reimbursement rate floors + billing infrastructure + Medicaid-credentialing pathways) other states will face when they implement similar mandates.
3. Tatyana Ali on obstetric violence: a celebrity-anchored maternal-mortality piece
Ali's public reporting on her own birth experience anchors the editorial: obstetric violence as a documented care-pattern, not a one-off complaint. The piece carries the Hoyert 2024 NCHS Health E-Stat 100 maternal-mortality figures (50.3 per 100,000 for Black women vs 14.5 overall) and the documented under-treatment-of-pain pattern. Three reader-action paths: name the experience, request specific clinical evidence for each intervention proposed, and identify a Black-aligned OB-GYN through the directory.
Resources we trust this week
Our directory is still in build-out. Three external resources continue to pass our editorial intake rubric:
- National Birth Equity Collaborative (birthequity.org) for maternal-health policy
- Therapy for Black Girls (therapyforblackgirls.com) for the Black-women therapy directory
Same disclosure as the prior two issues: we list these because their verification trails check out under our own intake rubric, not because they sponsor anything here.
A closing question
If someone in your family is living with dementia and you have ever had a clinician dismiss a behavioral symptom as "just part of getting older," what did you ask next? Write to hello@blackhealth.org. We read every response, and the patterns become reporting.
Until next week,
The Black Health Editorial team