Monthly Archive for October 2008

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October 31, 2008

Health and Educational Disparities in Autism: A Call for Action

The Center for Reducing Health Disparities along with the Cleveland State Center for Health Equity will host Nabil El-Ghoroury, PhD, Pediatric Psychologist at MetroHealth Medical Center and Senior Instructor in Pediatrics at Case Western Reserve University.

The title of his talk will be Health and Educational Disparities in Autism: A Call for Action. The lecture will take place on November 14 from 3:00 p.m. until 4:00 p.m. in R240 of the Rammelkamp Building at MetroHealth Medical Center. There is no fee and your parking will be validated.

To RSVP, please email or call Michele Abraham at or 216-778-3858.

Posted by: Staff on October 31, 2008
Category: Autism; Health Disparities; Health Inequities; Works in Progress

links for 2008-10-31

  • A study surveying patients in more than 1,500 physician practices has found racial and ethnic disparities in patient experiences, with minority patients having worse experiences than white patients. The findings suggest that while all doctors should be attentive to differences in patient experiences, Hispanic, Native American, and black patients are often visiting physician practices that are less patient-centered.
  • The investigators found that Black Canadians were significantly less likely than Caucasians to receive a kidney transplant, either from deceased or living donors. This situation mimics that seen in the United States. However, unlike African-Americans, Black Canadians who underwent a kidney transplant experienced no significant health differences compared with Caucasians after their procedure. Their transplanted kidneys survived just as long as kidneys transplanted into Caucasians, and Black Canadians actually survived longer following the surgery compared with Caucasians.

Posted by: Staff on October 31, 2008
Category: Lunch Break Reading

October 30, 2008

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  • Opponents say the measure could have unintended consequences, including driving up Medicaid costs. Supporters say it will keep the state from encroaching on the private sector.
  • Chinese AIDS victims are dying needlessly because a "tragic stigma" prevents them seeking help in a country where one fifth of people think the disease can be passed on by sharing a toilet, a top activist said on Thursday.
  • Our recent study of income-related inequalities in limiting long-term illness found the least generous Anglo-Saxon welfare states, England and Ireland, exhibited the largest health inequalities.
  • Striking new evidence has emerged of a widespread gap in the cost of health insurance, as women pay much more than men of the same age for individual insurance policies providing identical coverage, according to new data from insurance companies and online brokers.

Posted by: Staff on October 30, 2008
Category: Lunch Break Reading

October 29, 2008

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Posted by: Staff on October 29, 2008
Category: Lunch Break Reading

Who pays for the care of illegal immigrants?

A recent story chronicles the disparity in access to health care for some illegal immigrants.

The kidney failed when [Marguerita Toribio] briefly moved to North Carolina, which refused to pay for her anti-rejection drugs. She needed to go back on dialysis three days a week to clear toxins from her blood, but North Carolina didn't cover that either.

The best a social worker could offer was a prepaid plane ticket back to California.

Health services and other benefits available to illegal immigrants can vary by the state. Welfare, prenatal care or in-state college tuition might be available in one place and inaccessible across a state line.

Many states draw the line at illegal immigrants. But officials in California, New York and a few other states figure that not treating patients whose kidneys are failing costs more.

That is because patients without regular dialysis frequently end up in emergency rooms, on the brink of death. At that point, federal law requires that they receive dialysis until they are stable enough to be released -- usually only to deteriorate again within weeks and return to the ER.

Be sure to read the full article over at

Posted by: Staff on October 29, 2008
Category: Dialysis; Health Disparities; Health Inequities; Immigrant Health

October 24, 2008

links for 2008-10-24

  • Faced with a projected $500-million deficit this coming year, Ontario's finance minister announced that it will slow down the hiring of 9,000 nurses in order to save $50 million.
  • "The Cure," written and directed by student Anthony Onah. It's about a single mother whose young son is injured in an accident while she is at work. The family has no insurance, pulling them into an insurance nightmare almost as bad as the child's physical nightmare.

Posted by: Staff on October 24, 2008
Category: Lunch Break Reading

October 23, 2008

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Posted by: Staff on October 23, 2008
Category: Lunch Break Reading

October 22, 2008

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  • In 1980, black women and white women in Chicago with breast cancer were equally likely to die. Since then, death rates for white patients have improved dramatically. But that is not the case for their African-American counterparts, who are now dying at a rate 116 percent higher, according to data released Wednesday by the Metropolitan Chicago Breast Cancer Task Force.

Posted by: Staff on October 22, 2008
Category: Lunch Break Reading

October 21, 2008

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Posted by: Staff on October 21, 2008
Category: Lunch Break Reading

October 20, 2008

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Posted by: Staff on October 20, 2008
Category: Lunch Break Reading

China to return to universal health care

We have blogged before (here and here) about the declining access to health care in China due mostly to a shift in responsibility from the central government to the provincial governments. Since health care was paid for by tax dollars wealthy provinces got more care.

It seems that China is planning to reverse course and move towards universal health care.


The Chinese government, recognising the disparities in access to healthcare between the urban rich and rural poor, is planning to overhaul the world's largest health system. The plan, entitled "Healthy China 2020", aims to restore universal access to primary healthcare by 2010.

The Healthy China 2020 initiative was announced by the government about two months ago. "It will involve about 200 medical experts divided into seven special programmes," says Shanlian Hu of Fudan University in Shanghai, and author of a paper summarising the negative impacts of the free-market reforms.

The priority is to reverse the huge disparities in access to health, particularly between urban and rural populations.

Another big focus will be on prevention rather than treatment. Already, the government has vowed to restore universal access to primary healthcare within two years, And to prevent the scandal of doctors prescribing unnecessarily expensive treatments, the government will foot the drug bill and dictate which drugs are dispensed.

UPDATE: and have more information on the topic.

Posted by: Staff on October 20, 2008
Category: Access to Health Care; China; Health Disparities; Health Inequities; Universal Health Care

October 17, 2008

links for 2008-10-17

Posted by: Staff on October 17, 2008
Category: Lunch Break Reading

October 16, 2008

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  • In California, the fight is over balance billing patients who go to emergency rooms at hospitals that aren’t in their insurer’s network. Predictably enough, the insurers argue that the hospitals charge inflated rates for these patients, while the hospitals say the insurers only pay a pittance.
  • Infant mortality in the United States remains higher than in many other industrialized countries, with progress stalling this decade, the U.S. government said on Wednesday.

Posted by: Staff on October 16, 2008
Category: Lunch Break Reading

Health disparities in Baltimore

A story that appears online at the Baltimore Sun reports on a 20-year gap in life expectancy between wealthy and poor areas:

The two-decade difference in life expectancy between Hollins Market and Roland Park was revealed in data released yesterday by the city Health Department, which for the first time has compiled comprehensive death data on a neighborhood level.

The results are striking. In some impoverished neighborhoods, the death rates from heart disease and stroke are more than twice as high as in wealthier places just a few blocks or miles away. At the extreme, the difference in mortality rates between some neighborhoods is as wide as the disparity in life expectancy between the United States and a Third World nation such as Burma.

Posted by: Staff on October 16, 2008
Category: Health Disparities; Health Inequities; Social Determinants of Health

October 15, 2008

links for 2008-10-15

  • The World Health Organization is urging governments to adopt primary health care and universal coverage as the best ways of improving health and saving lives.
  • An e-mail survey of 1,767 adults currently being treated for cancer found 569 respondents with late-stage cancer. Of those, 12% said they passed up recommended treatment because it was too expensive.
  • More than 20 Chicago medical and public health organizations came together to provide an interactive approach to the health disparity problem in the city. They were taught to pay more attention to cultural influences on health, low levels of health literacy in the public and how even the smallest of biases can affect quality of care.
  • Under new state rules that take effect today, hospitals and physicians are barred from billing patients for the balance of emergency care not covered by insurers.

Posted by: Staff on October 15, 2008
Category: Lunch Break Reading

October 14, 2008

links for 2008-10-14

Posted by: Staff on October 14, 2008
Category: Lunch Break Reading

Meredith Minkler Lecture

Nationally reknown scholar Meredith Minkler, DrPH, MPH will present “Collaborative Research with Communities: Challenges and Opportunities for Addressing Health Disparities” in room R240 of the Rammelkamp Building at MetroHealth Medical Center on October 15 at 12:30 p.m.

Dr. Minkler is Professor and Director of Health and Social Behavior at the School of Public Health, University of California, Berkley. She has 30 years experience in community partnerships, community based participatory research and work with diverse community groups. She has published over 100 articles, peer-reviewed journals and 7 books. Please RSVP to Ayella Shams at 216-778-8481 or

Posted by: Staff on October 14, 2008
Category: Health Disparities; Heath Inequities

Report finds significant child health disparities

Ohio Health Policy is reporting on a new by the Robert Wood Johnson Foundation:

"The bad news is that we have these very large gaps, which can be thought of as shortfalls in the health potential of our children," said lead author Dr. Paula Braveman. "But the patterns we see tell us that these gaps are fixable if we as a society put our will to the task."

The Health Care Blog has an excellent write up on the topic.

You can find the study at

Posted by: Staff on October 14, 2008
Category: Health Care; Health Disparities; Health Inequities; children

October 09, 2008

links for 2008-10-09

  • The drug maker Pfizer earlier this decade manipulated the publication of scientific studies to bolster the use of its epilepsy drug Neurontin for other disorders, while suppressing research that did not support those uses, according to experts who reviewed thousands of company documents for plaintiffs in a lawsuit against the company.
  • Boston University Goldman School of Dental Medicine has received a $14.5 million grant to fund the Center for Research to Evaluate and Eliminate Dental Disparities until 2015.
  • In 1960, the U.S. ranked 11th in the world in infant mortality rate. In 2004, it was 29th. Further, in 1960 white Americans on their own would have ranked 11th in the world in that category, while African Americans would have been 30th. In 2004, white Americans would have ranked 26th, while African Americans had fallen to 35th.
  • Three men who say they have adequate health coverage and enough money to pay for their health care needs want to opt out of hospital coverage under Medicare. Federal rules say they cannot collect Social Security benefits if they do that.

Posted by: Staff on October 09, 2008
Category: Lunch Break Reading

JAMA reports on racial disparities in breast cancer treatment

From JAMA:

A recent analysis presented at the symposium by researchers at the M. D. Anderson Cancer Center in Houston revealed that black women are less likely than white women to receive radiation therapy after lumpectomy, which is the standard of care. The study, which is the first to look at radiation therapy rates on a national scale and to compare differences among US regions, also showed that radiation rates after lumpectomy in general are lower than they should be.

Another study sought to identify the reasons for higher mastectomy rates in rural areas. A long-held belief is that mastectomies are more common among women who live in rural areas because they do not have the same access to postlumpectomy radiation therapy as urban women. However, this study found that women in rural and urban areas have equivalent rates of radiation therapy following breast cancer surgery.

Posted by: Staff on October 09, 2008
Category: Breast Cancer; Health Care; Health Disparities; Health Inequities

October 08, 2008

links for 2008-10-08

  • Universal health care is, however, a moral obligation for an industrialized society, and will not result in the apocalyptic consequences promised by the jeremiads.
  • Survival after a head and neck cancer diagnosis lags for African-Americans and the poor, researchers here said.
  • Discussing the disparity between mental health care and general medicine in the country, Duckworth said the bias against mental illness goes beyond the institutions — hospitals, insurance companies, states — and encompasses society.
  • The statistics are startling: One out of every 166 children nationwide has some form of autism, according to the Centers for Disease Control and Prevention.
  • Asthma patients who are black tend to have more severe disease than asthma patients who are white, leading to more asthma control problems, higher rates of emergency department visits, and overall worse quality of life.

Posted by: Staff on October 08, 2008
Category: Lunch Break Reading

African Americans have a dramatically worse prognosis for head and neck cancer

In a study published this week in the journal Cancer researchers report that African-Americans with head and neck cancers have a shorter survival time than whites (21 months vs. 40 months) and that the difference "is not explained completely by demographics, comorbid conditions, or undertreatment because poor outcomes continued to be observed after correcting for these factors. Earlier diagnosis, particularly in those from low SES groups and among AA patients, is needed to improve outcomes."

MedPage Today has a good review of the article.

Posted by: Staff on October 08, 2008
Category: African-American Health; Cancer; Head and Neck; Health Disparities; Heath Inequities

October 06, 2008

links for 2008-10-06

Posted by: Staff on October 06, 2008
Category: Lunch Break Reading

Minorities with disabilities suffer most

From Reuters:

During 2004-2006, an estimated 20% of US adults, or 1 in 5 people, had some level of disability and these individuals -- particularly individuals from certain minority groups -- were much more likely to rate their health as fair or poor compared with persons without a disability.

Black, Hispanic and Native Americans with a disability reported fair or poor health at disproportionately higher rates than White and Asian Americans, health officials with the Centers for Disease Control and Prevention reported Thursday in the agency's weekly report on illness and death.

The full report can be found at MMWR.

Posted by: Staff on October 06, 2008
Category: Access to Health Care; Disabilities; Healthcare; Heath Inequities

October 03, 2008

links for 2008-10-03

Posted by: Staff on October 03, 2008
Category: Lunch Break Reading

Health disparities in Erie PA


In 2000, the study reported, Erie County's population was 93.6 percent caucasian, 6.1 percent black and 2.2 percent Hispanic. Yet the poverty rate for children under 18 was 46.6 percent for the black population, compared with 11.4 percent for whites. Erie County's poverty rate for children was higher than both the Pennsylvania and national rates.

The percentage of births to single women and to teens (including young teens) in the black community in Erie was also considerably higher when compared with the majority population. The percentage of females who received prenatal care was lower for black women than for whites in Erie County. The mortality rate for black babies was also higher compared to white babies.

Those statistics pointed to a gap in health care from the very start of life.

Posted by: Staff on October 03, 2008
Category: Health Disparities; Heath Inequities

October 02, 2008

links for 2008-10-02

Posted by: Staff on October 02, 2008
Category: Lunch Break Reading