closing the Gap: Experts Urge Expanded Diagnostics to Combat Health Inequities
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Health equity is increasingly recognized as a critical concern within the healthcare system, adn a key strategy for achieving it lies in expanding access to diagnostic testing. Experts at Infectious Disease Week 2025 emphasized that equitable practices are essential to ensuring all patients can reach their full health potential, regardless of socioeconomic factors.
A symposium titled “Lowering Barriers to diagnostics Access to Reduce Health Inequities and Improve Outcomes,” moderated by Ritu Banerjee, MD, PhD, brought together leading voices to discuss solutions. Panelists Jacinda Abdul-Mutakabbir, PharmD, MPH, of the University of California San Diego; Dina Greene, PhD, of the University of Washington; and karissa Culbreath, PhD, D(ABMM), of the University of New Mexico Health Sciences Center, highlighted how limited diagnostic access exacerbates disparities, notably in antimicrobial resistance (AMR) and sexually transmitted infection (STI) screening. Pharmacists, physicians, and othre healthcare providers are seen as vital in bridging these gaps.
The Outpatient Imperative: Expanding AMR Diagnostics
Abdul-Mutakabbir began by underscoring the global burden of AMR, noting approximately 3 million infections occur annually.Contrary to common perception, she explained that the majority of AMR cases are encountered in outpatient settings, despite the frequent association of these infections with healthcare-acquired circumstances.
Significant inequities exist in AMR infection rates, disproportionately affecting racially and ethnically minoritized (REM) individuals, those with lower socioeconomic status, and individuals with limited English proficiency. These disparities, Abdul-Mutakabbir asserted, are rooted in social determinants of health (SDoH) and systemic oppression. Access to education, economic stability, and timely healthcare are all crucial factors influencing AMR risk.
“If you have a health care provider shortage, you don’t have an access point to receive care,” Abdul-Mutakabbir stated.
Research from Abdul-Mutakabbir’s institution demonstrated a clear link between social vulnerability and chronic illness among REM patients with urinary tract infections (UTIs). Furthermore, studies have revealed that AMR UTIs incur approximately $2000 in additional costs compared to infections caused by susceptible pathogens. This economic burden underscores the need for proactive intervention.
Collaboration between pharmacists and physicians to integrate diagnostics into outpatient AMR efforts is thus paramount. Abdul-Mutakabbir stressed the importance of early detection of resistant microbes and prompt, appropriate treatment to reduce both the societal and economic impact of AMR. Integrating diagnostic tools alongside AMR stewardship programs is also essential. “There may be more costs upfront, but it can save millions on the backend,” she explained.
Simplifying STI Screening with Self-Collection
Greene shifted the focus to STI screenings, which face similar accessibility challenges. Barriers to testing include a lack of awareness about screening locations, fear of privacy breaches or stigma, and limited transportation options coupled with restrictive clinic hours. These obstacles contribute to a significant number of individuals remaining unscreened.
To address these inequities, Greene advocated for the expanded use of at-home self-collection methods. These methods offer increased convenience through easily accessible sample collection, small specimen volumes, and stable transport capabilities.
Research indicates that self-collection is not only more equitable but also as effective – and sometimes more effective – than traditional provider-collected samples. A recent study published in Am J Clin Pathol (2025;163(3):406-410. doi:10.1093/ajcp/aqae135) by Navas ME, Musoke L, Epps PV, et al. demonstrated the feasibility of extragenital self-collection testing for gonorrhea and chlamydia within the Veterans Health Management. The study found high patient acceptance and completion rates, suggesting that self-collection could significantly expand STI screening reach.
- Navas ME, Musoke L, Epps PV, et al. Extragenital self-collection testing for gonorrhea and chlamydia: A feasibility study for expanding STI screening in the veterans Health Administration. Am J Clin Pathol. 2025;163(3):406-410. doi:10.1093/ajcp/aqae135
