The most recent recommendations from the 2020 National Asthma Education and Prevention Program Update and Global Initiative for Asthma 2021 guide evidence-based clinical decision making. However, given the present state of health disparities by age, income, and race, the equitable implementation and dissemination of these guidelines will be unlikely without further guidance. This work group report reviews the current state of the new asthma guideline implementation; presents updated evidence-based therapeutic options with attention to specific patient populations; and addresses barriers to the implementation of these guidelines in minoritized, historically marginalized, and underresourced communities. Allergists and immunologists can use practical ways to accomplish the goals of improved asthma care access and advanced asthma care across the life span, with specific considerations to historically marginalized populations. Modifiable barriers to guideline implementation include financial barriers, environmental factors, and allergy subspecialty access and care coordination. Various programs to improve access to guideline-based asthma care include community programs, school-based asthma programs, and digital health solutions, with an emphasis on reducing disparities by race.

OBJECTIVE: To provide guidance for guideline developers on how to consider health equity at key stages of the guideline development process.
METHODS: Literature review followed by group discussions and consensus building.
RESULTS: The key stages at which guideline developers could consider equity include setting priorities, guideline group membership, identifying the target audience(s), generating the guideline questions, considering the importance of outcomes and interventions, deciding what evidence to include and searching for evidence, summarizing the evidence and considering additional information, wording of recommendations, and evaluation and use. We provide examples of how guidelines have actually considered equity at each of these stages.
CONCLUSIONS: Guideline projects should consider the aforementioned suggestions for recommendations that are equity sensitive.

OBJECTIVE: This article introduces the rationale and methods for explicitly considering health equity in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology for developing clinical, public health, and health system guidelines. This article is a German translation of the original version published in English.
METHODS: We searched for guideline methodology articles, conceptual articles about health equity, and examples of guidelines that considered health equity explicitly. We held three meetings with GRADE Working Group members and invited comments from the GRADE Working Group listserve.
RESULTS: We developed three articles on incorporating equity considerations into the overall approach to guideline development, rating certainty, and assembling the evidence base and evidence to decision and/or recommendation.
CONCLUSIONS: Clinical and public health guidelines have a role to play in promoting health equity by explicitly considering equity in the process of guideline development.

Many programs have been designed to increase the number of minorities participating in medical education. Despite these programs, the number of underrepresented minorities (URMs) has never reached the level of representation as is noted in the general census reporting of 12-13%.Using a focused literature review methodology, the Cobb Institute W. Montague Cobb Institute/NMA Health Institute (The Cobb Institute)1 reviewed articles from medical and social science publications to elucidate the causes for the dearth of URMs. Multiple articles have been written to examine this phenomenon and they have identified many challenges. Factors identified include stigmata and stereotyping, growing up in under resourced communities, sub-standard public education opportunities, lack of role models and mentors, lower standardized test scores, and admissions committee practices; all negatively impact URMs on the path to graduate medical education. The W. Montague Cobb Institute/NMA Health Institute (The Cobb Institute) has identified many common impediments along the path to matriculation and offer recommendations and strategies to address the URM matriculation issue. The Cobb Institute concluded there is a substantial need to invest more in \'working\' programs with proven outcomes aimed at increasing admittance into medical schools for black males in particular and URMs in general. PURPOSE: The purpose of this paper is to discuss and identify effective programs and strategies used to increase admissions of underrepresented minorities (URM) in general, and black males in particular, into medical school. We will examine best practices and make recommendations regarding successful actions which can lead to increasing black males in the admissions process.

OBJECTIVE: The aim of this paper is to provide detailed guidance on how to incorporate health equity within the GRADE (Grading Recommendations Assessment and Development Evidence) evidence to decision process.
METHODS: We developed this guidance based on the GRADE evidence to decision framework, iteratively reviewing and modifying draft documents, in person discussion of project group members and input from other GRADE members.
RESULTS: Considering the impact on health equity may be required, both in general guidelines and guidelines that focus on disadvantaged populations. We suggest two approaches to incorporate equity considerations: (1) assessing the potential impact of interventions on equity and (2) incorporating equity considerations when judging or weighing each of the evidence to decision criteria. We provide guidance and include illustrative examples.
CONCLUSIONS: Guideline panels should consider the impact of recommendations on health equity with attention to remote and underserviced settings and disadvantaged populations. Guideline panels may wish to incorporate equity judgments across the evidence to decision framework. This is the fourth and final paper in a series about considering equity in the GRADE guideline development process. This series is coming from the GRADE equity subgroup.

OBJECTIVE: To provide guidance for guideline developers on how to consider health equity at key stages of the guideline development process.
METHODS: Literature review followed by group discussions and consensus building.
RESULTS: The key stages at which guideline developers could consider equity include setting priorities, guideline group membership, identifying the target audience(s), generating the guideline questions, considering the importance of outcomes and interventions, deciding what evidence to include and searching for evidence, summarizing the evidence and considering additional information, wording of recommendations, and evaluation and use. We provide examples of how guidelines have actually considered equity at each of these stages.
CONCLUSIONS: Guideline projects should consider the aforementioned suggestions for recommendations that are equity sensitive.

OBJECTIVE: This article introduces the rationale and methods for explicitly considering health equity in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology for development of clinical, public health, and health system guidelines.
METHODS: We searched for guideline methodology articles, conceptual articles about health equity, and examples of guidelines that considered health equity explicitly. We held three meetings with GRADE Working Group members and invited comments from the GRADE Working Group listserve.
RESULTS: We developed three articles on incorporating equity considerations into the overall approach to guideline development, rating certainty, and assembling the evidence base and evidence to decision and/or recommendation.
CONCLUSIONS: Clinical and public health guidelines have a role to play in promoting health equity by explicitly considering equity in the process of guideline development.

OBJECTIVE: To examine the relationship between radiation therapy resources and guideline-concordant radiotherapy after breast-conserving surgery (BCS) in Kentucky.
METHODS: The SEER registry and Area Resource File provided county-level data describing cancer care resources and socioeconomic conditions of Kentucky residents.
METHODS: The outcome variable was rate of BCS without radiotherapy in each county for 2000-2007. Eight-year weighted average rates of radiation therapy providers and hospitals per 100,000 residents were explanatory variables of interest. Exploratory spatial data analyses and spatial econometric models were estimated.
RESULTS: Appalachian counties in Kentucky had significantly fewer radiation oncologists, hospitals with radiation therapy facilities, and surgeons per 100,000 residents than non-Appalachian counties. The likelihood of BCS without radiation was significantly higher among Appalachian compared to non-Appalachian women (42.5 percent vs. 29.0 percent, p < .001). Higher proportions of women not receiving recommended radiotherapy after BCS were clustered in Eastern Kentucky around Lexington. This geographic disparity was partially explained by significantly fewer radiation therapy facilities in Appalachian Kentucky in adjusted analyses.
CONCLUSIONS: Scarce radiation therapy resources in Appalachian Kentucky are associated with disparities in receipt of guideline-concordant radiotherapy, suggesting that policy action is needed to improve the cancer treatment infrastructure in disadvantaged mountainous areas.