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May 15, 2008

Thursday Photovoice - Photo 2

This is the second in a series of entries that will highlight photographs taken as part of the photovoice component of Project HYPE.

Abandoned houses are everywhere. There used to be stores and people living in there. Now everything has changed. (caption by the participant)

You can read more about Project HYPE and see other photographs at our photovoice page.

Check back next Thursday when we will highlight another photograph.


EXTRA: Ohio Health Policy Review is reporting on the disparity in death rates between different levels of education.

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Posted by David Porter at 08:00 AM | Comments (0)
Category: Photo Voice; Research; cbpr; foreclosure; hypertension; photovoice; stress

May 14, 2008

Cool Whip #1

This is the first of a weekly series.

NYTimes.com - The Lost Supermarket

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Posted by David Porter at 08:00 AM | Comments (1)
Category: Cool Whip; Nutrition; fast food; grocery stores; supermarkets

May 13, 2008

Vet commits suicide outside veterans' clinic

On Saturday the Health Disparites Blog celebrated its 2nd birthday. I had planned on posting today the first in a new series of comics focused on the topics of health and healthcare.

Then last night I stumbled upon a terribly sad story at curethis.org that was originally posted at greenvilleonline.com:

Harriett Chapman's eyes filled with tears Sunday as she recalled one of the last conversations she had with her 89-year-old father before he fatally shot himself outside a Greenville veterans' clinic last month.

Grover Cleveland Chapman told his family, "No matter what I apply for at the VA, they turn me down," she recalled.

The next day, the World War II veteran took his own life outside the Veterans Outpatient Clinic at 3510 Augusta Road, said Greenville County Deputy Coroner Mike Ellis.

Somehow posting a comic today just didn't feel right.

EXTRA: GoozNews.com posted an interesting article about the FDA and the Helsinki Declaration.

Last week, the FDA formally declared that it will no longer require that clinical trials submitted to the agency to get regulatory approval for a new drug adhere to the Helsinki Declaration. The new rule, which goes into effect next October, was supported by the drug industry but opposed by numerous public interest, patient advocacy, and consumer groups.

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Posted by David Porter at 08:00 AM | Comments (0)
Category: Health Care

May 12, 2008

How the cost of medical school can affect health care quality

Andrew Herstein writing at theNation.com explains how the cost of medical school affects both patient care and health care access.

According to the article, in 2006 graduates of public medical schools owed a median amount of $120,000 in student debt. Their private school counterparts owed $160,000.

Citing 2004 U.S. Census Bureau statistics Mr. Herstein shows that while minorities make up 30% of the U.S. population only 14% of applicants to schools that grant an M.D are minorities. From theNation.com:

According to the Association of American Medical Colleges (AAMC), the primary reason for this discrepancy is that minority students are much more likely to see financing a medical education as an insurmountable problem.

The article continues by showing how race matters with regards to health care providers.

Patients report higher measures of satisfaction and trust when their doctor is of the same race and ethnicity. One study found that race-concordant visits were longer on average and were characterized by more positive physician affect. In addition, minority physicians are more likely than white physicians to practice in geographic areas whose populations face multiple challenges to maintaining good health.

In addition, minority doctors report providing more care for under-served populations.

So what should be done about the low number of minority applicants to medical school? Mr. Herstein offers two possible solutions.

First the U.S. government could work towards reducing the cost of medical school for qualified college graduates. This could be accomplished by increased funding for scholarship programs that reward those who work in under-served areas.

The second possible solution is to provide more money to health professions schools which should increase the number of need based scholarships.

With the rising cost of tuition the article ends with a warning that things could get worse:

If such rapid tuition growth continues, larger and larger numbers of minority students will consider a medical education to be unaffordable. The result would be a workforce that is even less diverse than it is now. Considering the many benefits that a diverse workforce provides, this outcome should be avoided. The federal government has the ability to shape the composition of the physician workforce and ought to do so.

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Posted by David Porter at 08:30 AM | Comments (0)
Category: Health Care; Healthcare; health care access; medical school; medical school debt

May 09, 2008

Cultural and Linguistic Competency - Implications for Reseach

On May 19th there will be a half-day symposium looking at techniques for designing research projects sensitive to cultural dynamics of patient population.

The guest speaker and facilitator will be Tawara D. Goode, M.A. Ms. Goode is an Assistant Professor and Director of the National Center for Cultural Competence at the Georgetown University Center for Child and Human Development.

Date: May 19th, 2008
Time 8:00 - 1:00 p.m.
Location: Wolstein Research Building, Room 1413, Case Western Reserve

You can download a pdf version of the flyer for the event here.

Please RSVP to Michele Abraham at 216-778-3858 or mabraham@metrohealth.org no later than May 12, 2008.

This symposium is sponsored in part by Case Western Reserve University, the Francis Payne Bolton School of Nursing, and the Clinical & Translational Science Collaborative.

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Posted by David Porter at 08:00 AM | Comments (0)
Category: Cultural competency; Cultural competency; Linguistic Competency; Research

May 08, 2008

Thursday Photovoice - Photo 1

This is the first in a series of entries that will highlight photographs taken as part of the photovoice component of Project HYPE.

It’s hard to walk when there are openings on the sidewalk.
(caption by the participant)

Project HYPE is a community-based research project aimed at identifying the social context of hypertension management. The photovoice aspect of the project is designed to have community members photograph those things which positively and negatively affect their hypertension. Participants told the story behind each photo which stimulated dialogue about the issues related to hypertension management.

Check back next Thursday when we will highlight another photograph.


BONUS: I will be attending Case's Collaboration Technology and Engaging the Campus today. I'm looking forward to meeting many of the best and brightest of the Case digital community.

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Posted by David Porter at 08:00 AM | Comments (0)
Category: Photo Voice; Research; cbpr; community; hypertension; photovoice

May 07, 2008

Racial disparities in diabetes control

From Renal and Urology News:

DIABETES CONTROL may be more challenging for Hispanics than for non-Hispanic whites, a meta-analysis suggests.

Researchers found that hemoglobin A1c (HbA1c) levels are higher in Hispanics than non-Hispanic whites, with an overall mean HbA1c difference of 0.5%. The reasons for the disparity in HbA1c levels are not known, but plausible explanations include differences in biology, access to care, insurance status, and diabetes treatment adherence

BONUS: New York City started issuing citations to restaurants that did not have calories posted on their menus. See NYTimes.com for more info.

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Posted by David Porter at 08:00 AM | Comments (0)
Category: Health Disparities

May 06, 2008

Engaging community members for research purposes: Who benefits?

The Case Center for Reducing Health Disparities and Cleveland State's Center for Health Equity are hosting the next presentation in the Works in Progress Lecture Series.

“Engaging community members for research purposes: Who benefits?”

Date
Friday, May 9, 2008.

Time
3-4 p.m.

Location
Case Western Reserver University School of Medicine
2109 Adelbert Avenue.
T503
(the School of Medicine is #50 on this map.)

Please RSVP your attendance to Cydney Johnson at cjohnson3@metrohealth.org or by phone at (216) 778-8484.

We look forward to seeing you there.


BONUS: a NYTimes.com story reports that high blood pressure is a greater risk in poor and middle income countries.

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Posted by David Porter at 08:00 AM | Comments (0)
Category: Works in Progress

May 05, 2008

Health care delivery problems in Canada

Often when the issue of health care access is discussed someone will point north and advocate for a Canada-styled heath care system for the U.S.

But there are problems in the Canadian health care system too. From theglobalandmail.com:

Canada, once able to boast about its high rank in the world for low infant-mortality rate – sixth place in 1990 – saw its rank plummet to 25th place in 2005, according to figures published this year by the Organization for Economic Co-operation and Development.

Specifically, Canada's infant mortality rate of 5.4 deaths per 1,000 live births is tied with Estonia's and more than double Sweden's rate of 2.4.

According to the OECD the infant mortality rate for the U.S. was not listed for 2005 but it was 6.8 (deaths per 1000 live births) for 2004.

In addition, the waiting times for many procedures in Canada seems long. In a report titled The Wait Time Strategy (available as a pdf at the health.gov.on.ca website) the number of days between decision to treat and treatment is listed. These are the average number of days waiting for December 2006 and January 2007.

Cancer Surgery 68 days
Angiography 28 days
Angioplasty 17 days
Bypass Surgery 48 days
Cataract Surgery 183 days
Hip Replacement 257 days
Knee Replacement 307 days
MRI 105 days
CT 62 days

If interested, you can navigate the Canadian health care website and check the average waiting times for various hospitals and geographic areas in Ontario.

Bonus: The next lecture in our Works in Progress series will be titled, "“Engaging community members for research purposes: Who benefits?" Check back tomorrow for full details.

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Posted by David Porter at 06:46 AM | Comments (0)
Category: Health Care

May 02, 2008

Disparities in nutrition among poor women

From Reuters:

Researchers found that among 603 mothers of children in Head Start programs in Alabama and Texas, diets tended to be too low in important nutrients. But Hispanic mothers did generally get more fruits and vegetables than white and African-American mothers did, and a lower percentage of their daily calories came from fat.

On average, the study found, Hispanic women consumed what health experts consider an adequate amount of fruits and vegetables -- 4.6 cups per day, based on detailed dietary questionnaires.

In contrast, white and black women averaged between 2 and 3 cups per day, the researchers report in the Journal of the American Dietetic Association.

The study can be found in the Journal of the American Dietetic Association.

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Posted by David Porter at 08:30 AM | Comments (0)
Category: Health Disparities

House introduces Health Equity and Accountability Act

Representative Joe Baca writing at the Huffington Post:

Latino children are less likely to receive adequate medical care, such as routine examinations and vaccinations. Latinos and African-Americans comprise 60% of all HIV/AIDS cases in the country. It is evident that priority must be given to diminishing these health disparities. If we have any chance of fixing health care for our community as a whole, action must be taken now.

To help address this issue the House has introduced the Health Equity and Accountability Act, H.R. 3014.


Bonus: The journal, Archives of Surgery, is soliciting papers for a year long theme on the topic of disparities in health care.

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Category:

May 01, 2008

Access barriers and disparities in the disabled

Posting as part of Blogging Against Disablism Day.


In a 2007 commentary that appeared in JAMA the authors list previous research that demonstrates how disabilities affect treatment.

- Women with major mobility problems were less like to have received a PAP test in the prior three years than women without major mobility issues.

- 45% of women with major mobility issues reported have a mammogram in the previous 2 years vs. 64% of women without mobility issues.

- In a study of Los Angeles County residents with disabilities those who were black, had lower incomes, and were more severely disabled were more likely to report difficulties in accessing clinicians offices.

- In women with breast cancer those who were disabled were less likely to receive radiotherapy following breast-conserving surgery.


The authors close with a call to reduce structural barriers and emphasize form and function:

As health care facilities managers renovate structures, construct new buildings, and purchase equipment and furnishings, they should remember legal requirements as well as health care’s therapeutic mission. Environments with barriers will not foster healing and could endanger the safety and experiences of patients and employees. Form follows function. Healing, not handicapping, should guide design of environments to ensure health care access for all persons.

BONUS: The Medical Humanities Blog has the latest Health Wonk Review up. There are even a few Seinfeld references in the mix.

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Posted by David Porter at 08:00 AM | Comments (0)
Category: Health Disparities

April 30, 2008

Blogging Against Disablism Day

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On May 1st the Health Disparities Blog will join a host of other medical bloggers with an entry focused on the topic of health disparities and disabilities.

More information can be found here.

Make sure you check back tomorrow.

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Posted by David Porter at 12:22 PM | Comments (0)
Category: About Us

Cancer, stroke, and health disparities in China

nosmoking.jpg

China Daily is reporting on a new study by the Chinese Ministry of Health.

The study looked at the health of about 210 million Chinese across the nation. The primary finding was that cancer and stroke are the countries top killers.

In addition, the report found increasing disparities between the rural and urban areas of China.

The differences were reflective of the yawning gap between the country's rural and urban areas in terms of health awareness and living standards, [MOH spokesman Deng Haihua] said.

Disparities in economic development between rural and urban regions, which lead to an imbalance in medical care and health awareness, can influence the death rate in different areas, he said.

The number of deaths in the countryside was 19 percent higher than in urban areas. Within urban areas, the death rate in less developed western cities was 25 percent higher than in the more developed east.

Part of the problem is China's tremendous cigarette consumption. MSN reported that China consumes 2.3 trillion (2,300,000,000,000) cigarettes or two-fifths the world's total.

The China Daily article also mentions the infamous cucumber, "people in the rural regions of Hebei province like to eat homemade pickles that have high nitrite content, which can lead to cancer...."

You can read our other entries related to China at this link.

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Posted by David Porter at 08:00 AM | Comments (0)
Category: China

April 29, 2008

Hospital says payment before treatment

From the Health Blog at WSJ.com:

As a front-page article in today’s WSJ reports, hospitals are seeking cash upfront to reduce bad debt they’re experiencing amid a surge in patients who don’t pay their bills. Some are uninsured and other carry coverage that requires high co-payments.

Let us not forget a topic we blogged about earlier - medical credit scores and how they might influence treatment.

BONUS: A new study out reports that blacks have a 5x higher rate of amputations in the Chicago area.

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Posted by David Porter at 08:00 AM | Comments (0)
Category: Health Care

April 27, 2008

Low Medicaid reimbursement may lead to disparities

From Health Affairs:

PCPs in high-minority practices rely more heavily on lower-paying Medicaid reimbursements, devote more time to uncompensated charity care, and earn lower incomes. Magnifying these resource disparities, geographic areas with more high-minority practices tend to have lower Medicaid and private insurance reimbursements than those with fewer high-minority practices.

Our results indicate that the minority makeup of physicians' patient panels is associated with greater reports from physicians of difficulties providing high-quality care. At least some of this relationship appears to be explained by the lower resources flowing to high-minority practices. Two of the quality indicators most affected by Medicaid payment levels in our simulations, time spent per patient seen and difficulties getting timely reports from other providers, suggest the possibility that physicians may compensate for the lower revenue flows by increasing the volume of patients they see, reducing the time spent per patient seen, and perhaps devoting less time to coordinating and documenting care. This is despite the more complex psychosocial contexts and the language and cultural barriers that often complicate the treatment of lower-income and minority patients.

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Posted by David Porter at 08:00 AM | Comments (0)
Category: Health Care

April 25, 2008

Sold her house to open a clinic

CNN.com has a story posted about a doctor who left private practice, sold her house, and opened a clinic focused on providing health care for the poor.

In 2002, these efforts resulted in "The Clinic: Medical Center for the Uninsured," a charitable, sun-filled clinic that has since received more than 40,000 patient visits.

Individuals receive free or low-cost primary medical care across eight specialties, regardless of income or locality.

"Since there's no need to spend a lot of time doing paperwork, we have time to talk to the patient and really hear what they're saying," says Stuart. "So the patients go away feeling they've been heard, that they've been helped."

An arsenal of more than 100 local volunteers, including 20 retired and practicing physicians, assist Stuart in providing expert medical services to more than 800 patients per month from across the southeastern Pennsylvania, New Jersey and Delaware area.

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Category: Health Care

April 24, 2008

Health care around the world

Healthcare-Economist.com has been reviewing many of the national health care systems around the world.

The reviews are based on an article by Michael Tanner that appeared at Cato.org.

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Category: Health Care

April 23, 2008

Racist Doctors?

Rahul K. Parikh, M.D. writing at Salon.com:

In 2002, the Institute of Medicine issued a sobering report about health disparities in America. In that report, the IOM challenged assumptions by asking one very hard question: Do doctors treat minority patients differently? Its answer, after reviewing more than 100 studies, was yes, "evidence suggests that bias, prejudice and stereotyping on the part of health care providers may contribute to differences in care."

Dr. Parikh furthers the discussion with a Harvard Medical School study that used computer images to test for implicit racial biases.

In that study researchers recruited internal medicine and emergency medicine residents in the Boston and Atlanta areas. Participants logged into a website and read a clinical vignette while viewing a picture of a black or white person.

The participants were then asked a series of questions regarding the source and treatment of the problem.

In their analysis the Harvard researchers reported no explicit biases by the participants with regards to black and white Americans. However, with regards to implicit biases negative attributes were assigned to blacks more often than whites.

From the Harvard study:

Not surprisingly, most physicians did not admit to any racial biases explicitly. However, on the implicit measures of bias (IATs), most nonblack physicians demonstrated some degree of bias favoring whites over blacks. Participants’ scores on the race preference IAT showed a range of implicit race bias similar to previous experiments on nonphysicians.

Back to Dr. Parikh.

Does this mean that doctors are racist? No. In fact, the discrepancy between explicit and implicit biases in the Harvard study suggests the opposite. But it's clear deeper biases exist, and for several reasons.

First, and most important, doctors are people. There's plenty of evidence that well-intentioned people, whatever their background, possess and demonstrate unconscious negative racial attitudes and stereotypes. Doctors are no different. We share many common conceptions about race in America. We bring those influences, right or wrong, with us to the office.

Dr. Parikh adds that the medical decision making process is often complex and the pressure of time forces the doctor to use shortcuts to arrive at a diagnosis. Stereotypes are just one of those shortcuts.


BONUS: If you are curious about implicit biases there is an online test by the University of Chicago. It looks at your response time in dealing with black and white males with and without a gun. Nicholas Kristof reports his results in this NYTimes.com article.

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Posted by David Porter at 08:30 AM | Comments (0)
Category: Health Disparities

April 22, 2008

Disparities in the Organ Allocation System

"Disparities in Perceptions of the Organ Allocation System and Willingness to Donate Organs."

Presented by L. Ebony Boulware, MD, MPH, FACP

Date: Friday, April 25th from 9:00-10:30 a.m.
Location: MetroHealth Medical Center. 2500 MetroHealth Ave. Rammelkamp R219.

All are welcome to attend.

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Posted by David Porter at 02:54 PM | Comments (0)
Category: Health Services Research Seminar

Life expectancy - It goes beyond race

From Reuters:

Smoking, obesity and high blood pressure are taking the lives of women in Appalachia, Mississippi River states and parts of Texas, a team at Harvard School of Public Health reported.

"There has been increasing disparity in health in the U.S. population for two decades," said Majid Ezzati of the school's department of population and international health, who led the study.

Overall U.S. life expectancy increased mostly because of fewer deaths from heart disease, the No. 1 cause of death, and stroke. But by the 1980s, death rates started to head back up in many counties.

"The majority of these counties were in the Deep South, along the Mississippi River, and in Appalachia, extending into the southern portion of the Midwest and into Texas," Ezzati's team wrote.

While many of the worst-affected counties had a high black population, Ezzati found that white populations in poorer counties fared worse that whites elsewhere, too.

"It exists above and beyond race," he said.

The study can be found free and online at PLoS Medicine.

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Category: Health Disparities

April 21, 2008

The bleak effects of poverty

From SFGate.com:

Illustrating the profound societal impact of chronic poverty, a new report released Thursday by the Alameda County Public Health Department documents health disparities by neighborhood, income and race. It highlights a widening social, economic and health gap in the county - as poverty goes up, life expectancy goes down.

"The data are overwhelming," said Dr. Tony Iton, the county's public health director. "It is shocking. It is not unique to West Oakland. You see it in Bayview-Hunters Point, in Richmond, in Cleveland and Detroit."

You can read the executive summary of the report at acphd.org.

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Category: Health Disparities

April 18, 2008

Health care and the youth in Australia

Australia's Medicare system provides free or low-cost universal care to all individuals.

Australians under the age of 15 can obtain their own Medicare card linked to their parent's account. Because the accounts are linked parents have access to all of their child's medical information.

The Australian newspaper The Age has an article discussing a new proposal that will help young Australians keep their medical details private.

From The Age:

[I]magine for a moment that you are a 14-year-old confused about your sexuality. You're too embarrassed to discuss this with your parents, or perhaps you have unsympathetic parents or come from a dysfunctional family. Wouldn't it be in everyone's best interests if you could talk in confidence to a trusted GP about this?

The proposed solution is the automatic distribution of Medicare cards to all Australian youths when they reach age 13.

This change to the Australian system has two components. First, Medicare cards will be distributed automatically. No longer will teenagers need to enroll in the system. Second, the age for an individual (not linked) Medicare account is lowered from 15 to 13.

Here in the U.S. the debate is focused on whether or not universal health care should exist. In Australia the issue is how young a person should be when they get their own private universal health care account.

For more information on the Australian Medicare system you can visit these links:

Medicare Australia at Wikipedia

Medicare system blamed for GP wage disparity

The Health Care system in Australia

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Posted by David Porter at 08:00 AM | Comments (0)
Category: Health Care

April 16, 2008

What to do with healthcare?

Deane Waldman writing at the Huffington Post.

Imagine you are a doctor walking down the street. You come upon a woman lying on the sidewalk possibly unconscious. Surrounding this woman are four people each loudly suggesting a different way to help. One is urging a candy bar, while another is promoting his unique, patented guaranteed cure for today only: $19.95 plus tax. A third is trying to resuscitate the woman, and the fourth is threatening her with a charge of public drunkenness.

The woman down on the sidewalk is Healthcare. Those offering to help - in essence doctors-without-licenses - are legislators, insurance executives, expert consultants, and regulators. You are the doctor - the person responsible for making the patient (healthcare) better. What should you do?

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Category: Health Care

April 15, 2008

Environmental Justice, Public Health & Health Disparities

On Wednesday April 16, 2008, Dr. Sacoby Wilson will present:

“Environmental Justice, Public Health & Health Disparities”

Time: 9:30-11:00 am
Location: MetroHealth Medical Center - Rammelkamp Building - Room R240

All are welcome to attend.

For more information please contact Center Business Coordinator Cydney Johnson at 216-778-8484 or by email at cjohnson3@metrohealth.org.

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Posted by David Porter at 12:07 PM | Comments (0)
Category: About Us

April 11, 2008

Chartbook of health disparities research

The Commonwealth Fund has published a chartbook of research related to health disparities.

The goal of this chartbook is to create an easily accessible resource that can help policy makers, teachers, researchers, and practitioners begin to understand disparities in their communities and to formulate solutions. Given the magnitude of the body of disparities research, we do not intend to create an exhaustive report that simply presents existing data. Rather we seek to prompt thinking about why these disparities may exist, and more importantly, what may be done to eliminate these gaps.

You can download the chartbook as a PDF or PowerPoint file at CommonwealthFund.org.


BONUS: Check back Monday for notes from Episode 3 of Unnatural Causes.

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Category: Health Disparities

April 10, 2008

Preview of Episode 3: The Latino Paradox

Tonight's episode of Unnatural Causes discusses the Latino paradox. Why is it that recent Mexican immigrants are healthier than the average American? Why does this health advantage disappear within a generation?

Here is a video preview of tonight's show. Locally it will be broadcast on WVIZ (PBS 25) at 10 p.m.

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Posted by David Porter at 08:00 AM | Comments (0)
Category: Unnatural Causes

April 09, 2008

Addressing the Mental Health Disparities Evident in the African American and Latino Communities

"Addressing the Mental Health Disparities Evident in the African American and Latino Communities - A Grassroots Approach."

Presented by Marsha Mitchell Blanks, M.S.W., L.S.W. on March 14, 2008 as part of our Works in Progress series.


See this page for information on downloading and subscribing to our podcast.

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Posted by David Porter at 01:16 PM | Comments (0)
Category: Audio / Video

Health Disparities Podcasts

"Addressing the Mental Health Disparities Evident in the African American and Latino Communities - A Grassroots Approach." Presented by Marsha Mitchell Blanks, M.S.W., L.S.W.

Download Link (Video Podcast)


"Elder Abuse: Framing the Issue." Presented by Georgia Anetzberger, PhD, ACSW, LISW.

Download Link (Video Podcast)


"Using the Primary Socialization Theory to Predict Adolescent Substance Use and Sexual Risk Taking Behaviors." Shelley A. Francis, MPH, DrPH, CHES.

Download Link (Video Podcast)

To download simply right click and select 'save as.' (Quicktime may be required to view.)

If you use iTunes you can subscribe to our podcasts by clicking this link. This will launch iTunes. You can then click "subscribe" to automatically receive new podcasts when available.

For other podcast managers you can add the following link to your podcast feeds:

http://blog.case.edu/ccrhd/podcasts/rsscrhdpodcast.xml

Be sure to check out some of our other multimedia presentations by clicking on the Audio / Video link in sidemenu on the left.

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Posted by David Porter at 12:00 PM | Comments (0)
Category: Podcasts

Separate and unequal health care and the Republican response

The evidence is overwhelming that disparities in health outcomes exist. Nearly every day we post a link to a news story or scholarly article that looks at some aspect of health disparities.

The PBS special Unnatural Causes is helping to further push the discussion.

Given that income and education are huge factors in health outcomes not everyone is ready to accept that health is affected by factors more than just income and education.

Conservative radio talk show host Michael Medved argues that the disparity in life expectancy isn't due racism or social injustice but because those with more income and education make better choices:

Actually, the biggest reasons for wealthier people living longer lives reflect healthier habits: less smoking, better diet, more regular exercise, less divorce, fewer sexually transmitted diseases, and so forth. Educated and privileged people also get more and better information about protecting their own health, as well as more access to preventive care. The “inequalities” in life expectancy don’t indicate some profound injustice – in fact, it would be unjust and illogical if people who had created more wealth were unable to use those resources to secure better health outcomes.

It's unfortunate that Mr. Medved did not watch the PBS series prior to writing his commentary. From Episode 1 of the PBS special Unnatural Causes:

ADEWALE TROUTMAN: I’m clear that on the social gradient, that line that we talked about earlier, that I’m on the top of that line. I’m highly educated. I have a medical degree. I have several other degrees. I make good money. I live in a good neighborhood. But I know that according to the research, if you’re an African American, no matter what your social status, your socioeconomic status, your health outcomes are going to be worse than your white counterpart.

NARRATOR: African Americans die earlier and have higher rates than whites of many chronic diseases across the social gradient.

According to the PBS series, experiencing racism can be stressful. Chronic stress can have an adverse affect on the body's immune system making it more susceptible to illness and disease.

NARRATOR: Racial discrimination can be an added stressor, linked with high blood pressure, increased rates of infant death, coronary artery disease… Troutman knows what this can lead to. He authored a cornerstone study with former Surgeon General David Satcher on excess death among African Americans.

TROUTMAN: It was a national study and we found over 83,000 excess deaths per year in the African American community alone.

NARRATOR: 83,000 excess deaths each year. That’s the equivalent of a major airliner filled with Black passengers falling out of the sky every single day, every year.

It is not as simple as making better choices as Mr. Medved argues. It is about being treated as an equal and having equal access to care.


BONUS: RJ Eskow in an entry at the Huffington Post talks about the Republican response to the issue of unequal health care.

The Republican-dominated Florida State Senate is proposing to cut $803 million in health care financing for the low-income residents, the poor, and senior citizens -- a figure the Orlando Sentinel calls "staggering."

[John McCain] proposes to end tax benefits for employers providing health insurance. That would effectively scrap the current employer-funded system which, however imperfect, provides health coverage to millions of Americans today.

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Posted by David Porter at 08:30 AM | Comments (0)
Category: Health Disparities