Health Disparities

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Study: Western States Eliminate Race Gap on Key Health Measures

Researchers looked at how effectively patients had their blood pressure, blood sugar and cholesterol controlled. (Getty Images)

Researchers looked at how effectively patients had their blood pressure, blood sugar and cholesterol controlled. (Getty Images)

A major new study looking at health disparities across the U.S. finds that significant gaps in managing heart disease and diabetes persist — except in Western states, where the gap has been eliminated.

‘It’s possible to eliminate deeply ingrained racial disparities.’
Researchers at the University of Michigan and Harvard University looked at 100,000 Medicare patients who were enrolled in HMOs, called “Medicare Advantage” plans, from 2006 to 2011. While management of blood pressure, cholesterol and blood sugar improved overall, blacks “substantially” trailed whites everywhere except the Western U.S., an area from the Rocky Mountains to the Pacific, as well as Alaska and Hawaii.

“We were certainly hoping we would see indications of progress in eliminating disparities in the country as a whole,” said lead author Dr. John Ayanian, who heads the Institute for Healthcare Policy and Innovation at the University of Michigan. He said that while it was “disappointing” that disparities persisted, “it’s also heartening to see that … in the West, the disparities had been eliminated, and that was both surprising and encouraging.” Continue reading

Bill to Increase Abortion Providers on Governor’s Desk

(Craig Miller/KQED)

(Craig Miller/KQED)

By Elaine Korry

Once again, California has shown it is willing to buck national trends. While other states have been regulating abortion clinics out of existence, lawmakers in the Golden State have passed a measure that actually expands access to abortion services.

The bill, AB154 by Assemblymember Toni Atkins (D-San Diego), would permit certified midwives and specially trained clinicians, such as nurse practitioners and physician assistants, to perform what is called an aspiration abortion during the first trimester of pregnancy. The change in law is designed to broaden access to abortion in areas where few, if any, doctors perform the procedure.

In nearly half of California’s 58 counties, there are no abortion providers except for hospitals, which provide urgent care in case of emergencies. But especially in rural areas, women who want a first trimester abortion often must travel long distances to obtain one at an unfamiliar clinic. According to Atkins, that geographic disparity is unjustified. Continue reading

Study Finds Surprising Outcomes for Undocumented HIV Patients

By Mina Kim

(gernhaex/Flickr)

(gernhaex/Flickr)

While there hasn’t been much research into how well undocumented Hispanic immigrants do if they are infected with HIV,  a small study from researchers at Baylor adds to what’s known — and found some surprising results.

In the retrospective study researchers reviewed the cases of 1,620 HIV-positive adults at a clinic in Houston. Researchers looked at patients’ health one year after they started HIV treatment and compared between groups — African American, white, Hispanic — with undocumented Hispanics reviewed in a separate category.

“What we found was, though they entered care with more advanced HIV,” said lead researcher Thomas Giordano in reference to the undocumented Hispanics, “actually when we looked at their outcomes they did as well, if not better, than the other groups in the study.”

Giordano says the study did not look specifically at why this might be happening, but did recount what is known about undocumented immigrants and overall health status. From the study: Continue reading

Assembly Bill Seeks to Increase Number of Abortion Providers

Regulations around abortion providers in the U.S. (American Journal of Public Health)

Regulations around abortion providers in the U.S. (American Journal of Public Health)

Tuesday afternoon, on the 40th anniversary of Roe v. Wade, a group of state lawmakers and women’s advocates announced the introduction of a bill in the California Legislature aimed at expanding a woman’s access to abortion. Currently in California, only physicians are authorized to conduct early abortions. This new bill, AB 154, would authorize other clinicians — specially-trained nurse practitioners, certified nurse midwives and physician assistants — to perform early abortions.

“As a former administrator of a health clinic, I know how important timely care is for women,” Assemblymember Toni Atkins (D-San Diego), author of AB 154, said in a statement. “This bill will ensure that early abortion care will be available for women in California who need it.”

Four other states permit nonphysician clinicians to perform early abortions. Still, clinical evidence of safety had been lacking. Last week, a new study led by researchers at UCSF showed that early abortions performed by trained nurse practitioners, certified nurse midwives and physician assistants are “clinically equivalent” to those performed by physicians.

“Early abortion is safer than we thought overall, and there’s no difference in the complication rate between the two groups,” said lead author Tracy Weitz, UCSF professor of obstetrics and gynecology. The research team found a two percent complication rate — below the four percent rate they had expected. Complications were mostly minor.

In the study, published online by the American Journal of Public Health, researchers received a waiver from the state of California to permit training of nurse practitioners, certified nurse midwives and physician assistants to perform what are called surgical or aspiration abortions. Altogether, researchers analyzed more than 11,000 procedures. Continue reading

Hispanic Children Focus of New Study on Developmental Delay and Autism

Hispanic children have had a lower rate of autism than other children — although their cases tend to be more severe. Researchers had wondered — is there something protective about being Hispanic? Or is this a case of lack of access and lack of understanding of warning signs?

I think you can guess the answer. But proving it is generally better than guessing.

In one of the largest studies so far to compare development in Hispanic children and non-Hispanic children, researchers at the UC Davis MIND Institute wrote that Hispanic children “displayed more similarities than differences compared to non-Hispanics.” In the case of autism, they found that rates of autism were actually roughly the same between Hispanic and non-Hispanic children.

The study’s lead author, Virginia Chaidez, Ph.D. said the research filled in a piece of “large puzzle” and added “autism is a spectrum and it’s very similar across the board. So we’re pretty confident in promoting outreach and trying to encourage the Hispanic community to learn the signs very early in life.” Continue reading

ER Overcrowding Hurts Minorities Most

By Durrie Lawrence

San Francisco paramedics transfer a patient into an ambulance. (Justin Beck: Flickr)

San Francisco paramedics transfer a patient into an ambulance. (Justin Beck: Flickr)

Overcrowding in California emergency rooms disproportionately affects minority populations, according to a study published Monday in the journal Health Affairs. The findings shed light on flaws in the emergency care system that affect vulnerable populations, including communities of color, lead author Dr. Renee Hsia says.

Researchers used ambulance diversion rates to study overcrowding in 202 California hospitals. In ambulance diversion overtaxed hospitals alert ambulances to take patients to other emergency rooms in the surrounding area.

In short, Hsia’s team found that hospitals which served more minority patients were more likely to divert. This despite controlling for factors such as hospital ownership (nonprofit versus for-profit versus county-run) and the types of patients served. Hsia, who works as an emergency physician at San Francisco General Hospital, says this finding suggests that those hospitals are suffering a greater strain on their resources and a higher demand for emergency care. Continue reading

ENDGAME: Frontline Documentary Explores AIDS in Black America

By Alvin Tran

(Frontline: PBS)

(Frontline: PBS)

When the AIDS epidemic began thirty years ago, it was portrayed by the media as a white, gay man’s disease. As depicted in a Frontline documentary premiering Tuesday night on PBS, that wasn’t the complete story then, and it’s not the case now.

ENDGAME: AIDS in Black America” shows the tremendous disparity the HIV/AIDS epidemic has unleashed on the black community in the U.S. As Renata Simone, the documentary’s producer and director, described on KQED’s Forum Tuesday morning, African Americans make up about 12 percent of the nation’s population, but account for almost half of all people infected with HIV, the virus that causes AIDS. “Everyday, about 156 people get infected with HIV and half are black,” she told Forum host Michael Krasny.

The documentary features personal stories and interviews from HIV-positive individuals who come from black communities across the country including Oakland. Simone interweaves the role of prejudice, stigma, drugs and prostitution in contributing to the spread of HIV deep in the black community. Continue reading

Coaching Program Makes Exercise Fun For Kids

By Lyssa Mudd Rome

Todd Whitehead has become a mentor figure in addition to helping kids have fun while exercising. (Photo: Coaching Corps)

On a recent afternoon at BAHIA, a bilingual after school program in Berkeley, a small group of elementary school kids ran around breathlessly. They were playing “wolves and bunnies,” a tag game that takes some of its rules from basketball. Their coach Todd Whitehead played along, occasionally giving directions and stretching his hand out for a high-five. “Todd makes basketball seem fun,” said nine-year-old Kaydie. But this is about more than having fun. It’s a way for these kids to get the exercise they need.

Whitehead is a post-doctoral scholar in public health at U.C. Berkeley who has been coaching at BAHIA for three years. “My main goal,” he says, “is for the kids to have fun, get healthy, and get exposed to activities that will keep them healthy as they grow up.”

The Center for Disease Control (CDC) recommends that children get at least an hour of physical activity a day. But for many kids, that isn’t happening. Budget cuts in California have meant there often isn’t enough money for schools to offer PE or include sports in their after school programs. On top of that, low-income neighborhoods frequently lack parks or other safe places to play. Organized sports activities are limited.

Continue reading

More Than a Haircut — Get a Health Check Up Too

By Marnette Federis

Center Stage Salon Oakland's Lakeshore District hosted a health screening event for The Black Barbershop Program. (Photo: Marnette Federis)

Chris Holiday of Oakland has his blood pressure checked at Center Stage Salon in Oakland's Lakeshore District. The salon hosted a health screening as part of The Black Barbershop Program. (Photo: Marnette Federis)

Oakland’s Center Stage Salon was buzzing like any other busy Saturday morning last weekend. But salon clients weren’t there just to get haircuts. They also lined up to get their blood pressure and glucose levels checked.

It was all part of a nationwide effort — The Black Barbershop Program. The goal was to screen African American men for high blood pressure and diabetes by going to the place where you would easily find them – at the barbershop. The screenings are free and volunteers also gave out health information.

“I’d like to live a hundred years,” said James Fulbright, one of the hairstylists at the salon who was screened for high blood pressure and diabetes. “So I just try to keep myself healthy and I needed to be checked.”

According to program organizers, African American men suffer worse health outcomes compared to other racial groups. For starters, 40 percent of black men die prematurely from heart disease compared to 21 percent of white men.

Program organizers say African American men face a number of barriers and access issues when it comes to health including lack of affordable services, poor health education and insufficient services that cater to black men. Continue reading

Smoking or Schools: Which is More Important to Your Health?

(Raul Lieberwirth: Flickr)

Sorry, cigarettes are still terrible for you, but can a good school system lead to better health? (Raul Lieberwirth: Flickr)

Too often, we confuse health with health care. Health care comes from a doctor or hospital. But health comes from many places we don’t normally think of as health at all — things like good schools, safe neighborhoods and access to a variety of jobs. In other words, if you live in places without those things, you have a lower likelihood of enjoying good health.

Today, a new study from researchers at Stanford’s School of Medicine confirms that health disparities across the country have more to do with social factors than the color of your skin or where you live. In fact, the researchers say that some of these social factors even outweigh — gasp — the effect of cigarette smoking. (More on that later).

The study, Geographic and Racial Variation in Premature Mortality in the US, looked at counties across the United States and the likelihood of people living to age 70. Lead author Dr. Mark Cullen says this measure is a good alternative to looking at life expectancy, because it shifts attention to events that occur earlier in life. In particular, researchers found that educational opportunities, distribution of income and a mix of jobs accounted for better health outcomes across the population of a county. These “social determinants of health” as public health professionals call them, also explain health disparities between African-Americans and caucasians. “In most parts of the country,” Cullen says, “if African-Americans had the same advantages that their white counterparts had, almost ALL of the racial disparity would go away.” Continue reading