Monthly Archive for January 2009
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January 28, 2009
links for 2009-01-28
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California insurers are discriminating against women, charging them more for individual health insurance than men, the city of San Francisco maintained in a lawsuit filed Tuesday against the state regulators who govern them.
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Women are less likely than men to receive kidney transplants, and researchers at Johns Hopkins have found that this gap primarily affects older women -- even though they fare as well or better than men their age after a transplant.
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Using professional interpreters can also lead to better care for patients with limited English proficiency, but physicians and medical trainees underuse professional interpreters, frequently substituting their own limited spoken Spanish during clinical encounters.
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Mississippi blacks fare worse than their white counterparts in terms of life expectancy and infant mortality, according to a county-by-county report released on Monday
Posted by: Staff on January 28, 2009
Category: Lunch Break Reading
January 27, 2009
links for 2009-01-27
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Western Pennsylvania has the highest rate of blacks progressing to end-stage renal disease, or complete kidney failure, according to the latest report from the U.S. Renal Data System.
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Based on all three approaches for measuring disparities, researchers found that disparities between Hispanics and whites for two broad indicators of health care increased between 1996 and 2005, while disparities between blacks and whites remained roughly constant.
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Drama over language requirements for the head of an improved trauma network in China.
Posted by: Staff on January 27, 2009
Category: Lunch Break Reading
January 23, 2009
links for 2009-01-23
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The U.S. agency responsible for keeping the public safe from harmful drugs and foods was added to a list of "high-risk" areas of the federal government because it may not be able to adequately do its job, the Government Accountability Office said on Thursday.
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One in seven Americans under age 65 went without prescribed medicines in 2007 as drug costs spiraled upward in the United States, a nonprofit research group said on Thursday.
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In the year following Hurricane Katrina, the health of survivors 65 and over declined nearly 4 times that of a national sample of older adults not affected by the disaster
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People caring for family members with dementia commonly abuse them with behavior such as swearing and shouting, researchers said on Friday in a study that shows a more widespread problem than previously thought.
Posted by: Staff on January 23, 2009
Category: Lunch Break Reading
January 22, 2009
links for 2009-01-22
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Panelists who took part in a December 2008 webcast hosted by the Kaiser Family Foundation voiced optimism that as president, Barack Obama will work to eliminate ethnic and racial disparities in health care.
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Under a plan passed Wednesday by the State Council, China is set to spend more than $120 billion in the next few years to build hospitals and clinics as part of an effort to provide basic, universal health care. The government will also subsidize insurance to extend coverage to more of its citizens.
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Dramatic improvements in U.S. air quality over the last two decades have added 21 weeks to the life of the average American, researchers reported on Wednesday.
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Obama said he would address the disparity in Medicare and Medicaid reimbursement rates, in which rural providers often get paid less than their urban counterparts when they perform the same procedure.
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Among patients with lung cancer, black patients are less likely than white patients to undergo recommended lung resection, but the disparity in treatment does not appear to have an impact on outcomes, according to research published in the January issue of the Archives of Surgery.
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The recession has squeezed virtually all sectors and demographic groups. But black men, who have always faced higher unemployment rates than the national average, are taking a harder hit, data show.
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People who live in poorer neighborhoods in the U.S. are less likely to have easy access to supermarkets carrying a wide variety of fresh produce and other healthy food, an analysis of 54 studies confirms.
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As President Obama gets down to the business of increasing patients’ access to health coverage, some liberals in Congress are suggesting he take a page from the Bush administration’s playbook: expand community health centers.
Posted by: Staff on January 22, 2009
Category: Lunch Break Reading
Lost in translation
Imagine a family member is in the intensive care unit and you are about to have a conference with the doctor. How would that conference be different if you were a person with limited English proficiency?
That is the question asked by Case Center for Reducing Health Disparities faculty member J. Daryl Thornton, MD, MPH.
In this month's Critical Care Medicine, Dr. Thornton and his team report that when a family conference involving the withdrawing of life support or bad news needed to be translated, the clinician spoke less.
In non-translated conferences clinicians spoke for an average of 19.6 minutes while during translated conferences clinicians spoke for an average of 10.9 minutes. Interpreters spoke on average 7.9 minutes during the interpreted meetings.
Additionally, in those family conferences that were not translated clinicians offered more emotional support via verbal cues.
In an accompanying editorial (from which the title of this post is taken), Mark D. Siegel, MD, FCCP, writes that prior to family conferences doctors should meet with interpreters not only to discuss the content of the meeting, but to make sure the conference applies the same standards that are used with English speaking families.
Posted by: Staff on January 22, 2009
Category: About Us; Cultural competency; Linguistic Competency; emergency care; interpreter advocates
January 21, 2009
links for 2009-01-21
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Children who suffer physical abuse, death of a parent or other childhood adversity and are anxious or depressed are at increased risk of developing asthma in adulthood, a study suggests.
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Gordon Brown hailed the 'momentous day' for the NHS as the first Constitution ends the era of doctor knows best with list of rights and responsibilities for patients and staff.
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The new president has spoken eloquently and accurately on the problems plaguing many minority communities. But he knows that it takes more than words to bring about change. That’s why, to fulfill his promise of a new, better America, the number one priority should be to fix the nation’s massive health care disparities as soon as he takes office.
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Obama’s health care reform are focused on access, with cost second and quality somehow tied in. He didn’t mention access at all, and he tied quality and cost to science and technology.
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Slowly, and somewhat surprisingly, health care is atwitter.
Posted by: Staff on January 21, 2009
Category: Lunch Break Reading
January 20, 2009
links for 2009-01-20
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Women are less likely to receive kidney transplants than men, and researchers at Johns Hopkins have found that this gap primarily affects older women — even though they fare as well or better than men their age after a transplant.
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The U.S. Food and Drug Administration is a failed agency that the public should not trust, Cleveland Clinic’s Dr. Steven Nissen told The Plain Dealer in a preview of a talk he’s giving Monday.
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Three-quarters of children and adolescents with type 1 diabetes had insufficient levels of vitamin D in a study conducted by researchers at Joslin Diabetes Center.
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A new study from the Health Department reveals huge gaps in the care that New Yorkers with diabetes receive. If we see this in a city that is pro-active in diabetes care, then what is happening in the rest of the U.S.?
Posted by: Staff on January 20, 2009
Category: Lunch Break Reading
Monetizing Compassion
The New York Times is reporting on the changing culture of medicine.
In the piece, Pauline W. Chen comments on how a recent divorce case has evolved into a fight over compensation for a donated kidney:
It is hardly headline news anymore that kidneys and livers are available for a price. But what has been particularly worrisome about the Batista case is the ease with which that topic has gone from black market alleyways to local courthouses and national media. What should have been outrage over putting a dollar value on a human organ became curiosity over the accusations and the pictures of those involved. Many of us reading, listening to and even writing about the story — myself included — accepted the premise long enough to wonder how Dr. Batista and his “medical expert” came up with that high a figure or if it was even physiologically possible for him to take back the kidney.
Also linked in the story is a recent article that appeared in the New England Journal of Medicine. The authors write:
Researchers have described two types of relationships that involve giving a benefit to someone else. In a market relationship, when you provide goods or services, you expect to receive cash or bartered goods of similar value in return. In a communal relationship, you are expected to help when there is a need, irrespective of payment.
Medicine involves both kinds of interactions. It has marketplace elements that are inherent in any business — a physician receives payment for services. But there is also a communal relationship, an expectation and obligation to help when assistance is needed. We believe that in the current environment, the balance has tipped toward market exchanges at the expense of medicine's communal or social dimension.
Posted by: Staff on January 20, 2009
Category: Access to Health Care; Health Care; Health Care Costs; Market Based Health Care
January 16, 2009
links for 2009-01-16
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In a year-long study conducted in Dallas County, Texas, women who called 911 for suspected heart-related symptoms had a 52 percent greater likelihood of experiencing delays in emergency medical services (EMS) compared with their male counterparts, even after adjusting for a number of factors.
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Rural residents are more likely to suffer from diabetes by 16% than their city-dwelling counterparts, according to a first-of-its-kind study by researchers at the University of Illinois College of Medicine at Rockford.
Posted by: Staff on January 16, 2009
Category: Lunch Break Reading
January 15, 2009
links for 2009-01-15
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Even as President-elect Barack Obama plans an ambitious push to expand health coverage nationwide, states are slashing health services to their poorest residents amid the economic downturn.
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Hispanic voters turned out in droves last fall to elect Barack Obama and his Democratic allies on Capitol Hill. Those allies get their first chance to return the favor on Wednesday when the House takes up a children’s health care measure that would grant Medicaid coverage to children of new immigrants whose families came to the U.S. legally.
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India's fight to lower maternal and child mortality rates is failing due to growing social inequalities and shortages in primary healthcare facilities despite an economic boom, the United Nations said on Thursday.
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Under the [California] law, which took effect Jan. 1, health insurers are required to provide patients who lack English comprehension with an on-site interpreter or access to one through telephone or Web-hosted videoconferencing.
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More than half a million expectant and new mothers die each year, most in Africa and Asia where obstetrical and post-natal care is often unavailable and many pregnancies are complicated by HIV.
Posted by: Staff on January 15, 2009
Category: Lunch Break Reading
Interpreters in the doctor's office
In an earlier post we linked to an article in the Tennessean that reported on the challenges some doctors face when providing care to those with limited English skills.
Today, LATimes.com is reporting on a new California law that requires health insurers to provide interpreters for those with little or no English language ability.
Because [Maribel Pantoja] speaks only Spanish, there is usually an added level of anxiety when she visits a clinic. But a new first-in-the-nation state law requiring health insurers to provide interpreters for members with limited English skills spared Pantoja the confusion of trying to communicate with her doctor Tuesday.
Pantoja's face relaxed when she peered at a computer screen equipped with a webcam and saw an interpreter. After patient and interpreter greeted each other in Spanish, the nurse asked questions and Pantoja answered.
Afterward, Pantoja said the webcam made her latest visit to Los Angeles County-USC Medical Center better than the rest; she actually understood every word.
In addition to providing interpreters the law also requires health insurance companies to translate their forms into the top 2 languages of their members.
The law, Senate Bill 853, was originally signed in 2003 but shelved by Gov. Schwarzenegger.
While the law requires insurers to provider translation services there seems to be no mention of how the uninsured in California can obtain those same services.
Posted by: Staff on January 15, 2009
Category: Access to Care; Access to Health Care; California; Disparities; Health Care; Health Disparities; Health Inequities; Hispanic Health
January 14, 2009
links for 2009-01-14
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The reality of social change during the civil rights period is more complicated and more accessible than any savior myth. Social change begins from the bottom up, with everyday people joining together to make a change. They learn the necessary tools for investigation as well as for resolving conflicts in a nonviolent fashion and for engaging the community.
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Although more families are finding that they qualify for coverage for their children, many of the parents still make too much money to qualify for government-sponsored coverage, such as Medicaid, for themselves. The increase in requests for assistance also burdens already stretched state budgets.
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Surveillance data show higher rates of reported STDs among some minority racial or ethnic groups when compared with rates among whites.
Posted by: Staff on January 14, 2009
Category: Lunch Break Reading
STDs in Racial and Ethnic Minorities
A new report by the Centers for Disease Control and Prevention highlights some of the racial and ethnic disparities in sexually transmitted diseases.
From the report:
In 2007, approximately 48% of all chlamydia cases occurred among blacks. Overall, the rate of chlamydia among blacks in the United States was more than eight times that among whites.
In 2007, the gonorrhea rate among Hispanics was 69.2 which was higher than the rate among whites. This disparity is similar to that in recent years.
Between 2006 and 2007, the rate of P&S syphilis among American Indian/Alaska Natives increased 6.3%. In 2007, 0.7% of all cases of P&S syphilis reported to CDC were among American Indian/Alaska Natives.
Compared to whites, the 2007 rate for American Indian/Alaska Natives was 1.7 times higher.
The full report on sexually transmitted disease can be found at cdc.gov and here is a link to the section on STDs in Racial and Ethnic Minorities.
Posted by: Staff on January 14, 2009
Category: African-American Health; Asian Health; Disparities; Health Disparities; Health Inequities; STDs
January 13, 2009
links for 2009-01-13
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In Jacksonville - More than 13 percent of black infants are born with a low birth weight, compared with 7 percent of white babies.
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New findings are grim for women and their loved ones. Women who have the most serious type of heart attack and get to the hospital in time are less likely to get proper treatment and are less likely to survive than a man.
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The Food and Drug Administration does almost nothing to police the financial conflicts of doctors who conduct clinical trials of drugs and medical devices in human subjects, government investigators are reporting.
Posted by: Staff on January 13, 2009
Category: Lunch Break Reading
January 10, 2009
links for 2009-01-10
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Younger women have equal access to kidney transplants compared with their male counterparts, but older women receive kidney transplants much less frequently than older men, new research shows.
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Criticism by a national accreditation group over a lung cancer study that failed to disclose an author’s financial conflicts has led The New England Journal of Medicine to change its procedures.
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If an HMO and an ER can’t agree on what emergency care should cost, they shouldn’t take it out on the patient. That, basically, is what the California Supreme Court ruled yesterday.
Posted by: Staff on January 10, 2009
Category: Lunch Break Reading
January 08, 2009
links for 2009-01-08
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Medicaid provides coverage to poor and disabled Americans, many of whom face the highest burden of chronic disease owing to cultural and socioeconomic challenges. The program beats being uninsured, but it often relegates the poor to inferior care.
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Seniors who were hospitalized for a psychiatric illness were less likely to get recommended follow-up care if their Medicare plans required that they pay more for mental health care than for other medical care, researchers have found.
Posted by: Staff on January 08, 2009
Category: Lunch Break Reading
January 07, 2009
links for 2009-01-07
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Adolescents aren't just big kids, and too many start falling through cracks in the health care system when they pass the stage of preschool shots and summer camp checkups — what a major new report calls missed opportunities to shape the next generation's well-being.
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Because of long waits, some children who are brought to an emergency room never get treated before they and their caretakers have to leave.
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In a bid to put to rest legal troubles over a practice of canceling patients’ health insurance policies after they got sick, Blue Shield of California has agreed to grant coverage again to nearly 700 such patients.
Posted by: Staff on January 07, 2009
Category: Lunch Break Reading
January 06, 2009
links for 2009-01-06
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Women with early-stage breast cancer may live longer if they maintain a diet rich in fruits, vegetables, whole grains and low-fat dairy, a new study suggests.
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...as part of the informed-consent process, doctors have an ethical obligation to tell patients if they are more likely to survive, be cured, live longer or avoid complications by going to Hospital A instead of Hospital B.
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One person is diagnosed with diabetes every three minutes* in the UK, according to new figures from Diabetes UK.
Posted by: Staff on January 06, 2009
Category: Lunch Break Reading
Diet and survival in breast cancer patients
Reuters is reporting on a new study that appeared in the December 29th online edition of the Journal of Clinical Oncology.
From Reuters:
"Consumption of a diet high in fruits, vegetables, whole grains, and poultry, and low in red meat and refined foods may positively influence a woman's overall health and prevent other cancers and chronic diseases," Dr. Marilyn L. Kwan, a researcher at Kaiser Permanente in Oakland, California, told Reuters Health.
In addition, we know that in some poor neighborhoods residents have little access to stores that sell fresh fruits and vegetables.
It seems that not only is it important that people have access to affordable health care. Access to nutritional food is important as well.
Here in Cleveland the Healthy Corner Store Initiative works to have more healthy food available in neighborhood stores.
EXTRA: Even kids understand its important to get a referral first.
Posted by: Staff on January 06, 2009
Category: Breast Cancer; Cancer; Cancer Treatment; Health; Health Disparities; Healthy Foods; Women's Health; groceries; grocery stores
January 05, 2009
links for 2009-01-05
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In an article today, Canada’s National Post suggests that the increased demand that would follow health reform could lead to an exodus of Canadian doctors to the U.S.
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105-seconds isn't long enough to discuss the benefits of transradial angioplasty
Posted by: Staff on January 05, 2009
Category: Lunch Break Reading
How Elite Hospitals Rake in the Bucks
The Boston Globe has a series of articles that highlight how well some hospitals are doing while others are struggling financially.
BNET.com has an excellent summary of the series.
Among the highlights:
Most Massachusetts hospitals are nonprofits, yet the higher payments allow the elite institutions to snare patients and physicians from their rivals. “They are using that not-for-profit status to make a profit and to build more capacity for things we don’t need,” says John Chessare, former acting CEO of Caritas Christi, the state’s second-largest hospital chain.
...community hospitals are suffering. Twenty have closed during the 1990s, and two dozen more are currently losing money. In addition to the competitive threat, hospitals are seeing their own physicians leave to set up outpatient facilities that offer highly lucrative services such as radiology.
The article is well worth the read.
EXTRA: This Friday Earl Pike from the Greater Cleveland AIDS Taskforce will be presenting at our Works in Progress Series. You can find more info here.
Posted by: Staff on January 05, 2009
Category: Health; Health Care; Healthcare; Heath Inequities; Hospitals; insurance
January 02, 2009
links for 2009-01-02
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...the scarcity of general surgeons, most acute in rural areas where population density is too low to support the legions of surgical specialists that cluster in cities.
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People who live on Syracuse's South Side in ZIP code 13205 are about 3 1/2 times more likely to be hospitalized for preventable illnesses than Skaneateles residents who live in ZIP code 13152.
Posted by: Staff on January 02, 2009
Category: Lunch Break Reading