Monthly Archive for March 2009

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March 31, 2009

links for 2009-03-31

  • Reform of the U.S. healthcare system is vital this year because of growing costs and worsening care, the Health and Human Services Department said in a report on Monday.
  • The idea that mammography may do more harm than good may be alien to many American women.
  • The watchdog said NHS trusts must do more to meet their legal obligations to promote race equality following a review, which showed that examples of good practice existed but many trusts fell short on meeting basic requirements.
  • The African National Congress (ANC) plans to introduce national health insurance in its next term in government, party president Jacob Zuma said on Tuesday.
  • The prevalence of diabetes is at least twice as high in some ethnic groups as it is in whites. This is true even among people with similar body mass index (BMI) numbers, a large new study finds.

Posted by: Staff on March 31, 2009
Category: Lunch Break Reading

Why Twitter Works

(This post appears as part of our Tech Tuesday series.)

Twitter is the new social media darling. It has entered the domain of health, sports, entertainment, and emergency rescue. You can even find recipes in 140 characters or less.

Yesterday, people confirmed an earthquake via Twitter.

But with all this hype and promise does anyone know why Twitter works?

Henning von Vogelsang offers up a list of 10 things that make Twitter work. James Howard gives an example of Twitter working in the 'Great Conversation.'

But it's Daniel Miessler who I think gets closest to the mark. On his blog he writes:

Twitter, on the other hand, by having the deepest personal penetration (mobile phone) combined with the most ease of use (text message), has an effort rating that falls below most people’s natural resistance to participate, and its positive reward ratio is much higher because people are far more likely to respond to a text message than almost anything else.

Or as I would put it in 140 characters or less, Twitter works because it's simple.

Follow the Health Disparities Blog on Twitter.

Posted by: Staff on March 31, 2009
Category: Tech Tuesday; twitter

March 30, 2009

links for 2009-03-30

Posted by: Staff on March 30, 2009
Category: Lunch Break Reading

March 27, 2009

links for 2009-03-27

Posted by: Staff on March 27, 2009
Category: Lunch Break Reading

March 26, 2009

The Effect of Limited English Proficiency (LEP) on Health Outcomes

J. Daryl Thornton, MD, MPH presenting as part of our Works in Progress Series.

Video also available at

Posted by: Staff on March 26, 2009
Category: Audio / Video; Cultural competency; Health Care; Health Disparities; Health Inequities; Hispanic Health; Immigrant Health; LEP; Latinos; Limited English Proficiency; Works in Progress; emergency care; icu; interpreter advocates

links for 2009-03-26

  • Health disparities between indigenous and non-indigenous Australians will not end unless racism is tackled
  • A funny thing happened on the way to passage of Timothy's Law, which requires health insurers to provide coverage for mental illnesses. State legislators exempted three of New York's publicly subsidized health programs for low-income residents.
  • Inequality goes hand in hand with the social diseases that blight whole communities. The rational conclusion to be drawn from the mass of evidence that Richard Wilkinson and Kate Pickett have assembled is that all of us, irrespective of income, have much to gain from the creation of a more equal society.
  • In Wisconsin, American Indians have the highest rate of diabetes, at almost six times the rate of whites. African Americans and Hispanics have the second and third highest rates, nearly one and a half times more than whites, respectively. Asians have a diabetes rate just slightly higher than whites.

Posted by: Staff on March 26, 2009
Category: Lunch Break Reading

Health disparities between indigenous and non-indigenous Australians

The Independent Weekly has an article about health disparities in Australia.

The article reports on a new study that finds that up to 93% of indigenous people in urban South Australia have experienced racism.

As a result, these people sought out education and health care less often. Today, there is a 17 year gap in life expectancy between indigenous and non-indigenous Australians.

It should be noted that Australia has an universal health care system.

EXTRA: The Commonwealth Fund has a good overview of the health care system in Australia.

Posted by: Staff on March 26, 2009
Category: Australia; Cervical Cancer; Health Disparities; Health Disparities; Health Disparities; Racial Disparities; Racism; Universal Health Care

March 25, 2009

links for 2009-03-25

Posted by: Staff on March 25, 2009
Category: Lunch Break Reading

March 24, 2009

links for 2009-03-24

  • Community health centers saw a significant increase in patient load amid the state's efforts to improve health coverage by expanding public programs and making private insurance more affordable.
  • No one can deny the differences between ethnic groups when it comes to culture and language. But it seems race can dictate one's health, too. Some examples:
  • The worldwide epidemic of tuberculosis is mainly found in third world countries and is being monitored by the Centers for Disease Control and Prevention (CDC). About 1.5 million people die of TB every year. South Africa recently has been hit the hardest (infections of TB have almost tripled) because of the also high rate of HIV in people living there because treatment is expensive and ongoing and the patient’s immune systems are weakened.
  • A small recent study of refugees in schools in Stockholm found that Somalis were in classes for autistic children at three times the normal rate.

Posted by: Staff on March 24, 2009
Category: Lunch Break Reading

March 23, 2009

links for 2009-03-23

  • Black patients wait longer for hospital beds after being admitted into the emergency department than patients of other races
  • African Americans have a shorter life expectancy than whites, and cancer plays a major role in this disparity. African Americans are more prone to get cancer; they tend to present at a later, deadlier stage; and they have poorer survival rates after diagnosis.
  • Despite the fact that colorectal cancer screening among Medicare patients is increasing, gaps still remain between whites — who are screened most frequently — and other racial and ethnic groups, according to a new study by the University of California, Davis and the University of Washington. The biggest gap is between whites and Hispanics, who are screened at 47% and 33%, respectively. Asians and Pacific Islanders were screened at 42%, and blacks, 38%.
  • IF YOU THINK this is the era of e-government and transparency, it's time to think again. Hard as it is to imagine, there's a move afoot in Congress to take away the public's free online access to tax-funded medical research findings.

Posted by: Staff on March 23, 2009
Category: Lunch Break Reading

March 20, 2009

links for 2009-03-20

Posted by: Staff on March 20, 2009
Category: Lunch Break Reading

March 19, 2009

links for 2009-03-19

Posted by: Staff on March 19, 2009
Category: Lunch Break Reading

March 18, 2009

links for 2009-03-18

Posted by: Staff on March 18, 2009
Category: Lunch Break Reading

1 in 4 Americans lacks timely access to optimal care during time-sensitive medical emergencies

A recent study that appears in the Annals of Emergency Medicine reports on the access to emergency services for some Americans.

In the U.S. in general 71% of Americans live within 30 minutes of an emergency room. However, some areas are not so lucky. From Eureka Alert:

In South Dakota, for instance, just 13 percent of the population has access within 60 minutes to an emergency department that sees three or more patients per hour; in Montana, only 8 percent do. Even in the more populous, urban Northeast, only about half of residents in Maine and Vermont can reach one of those higher-volume emergency departments within an hour. Overall, the authors found that less than half of Americans have access to a teaching hospital, which tend to offer more sophisticated treatments and be staffed by subspecialists round-the-clock, in an hour.

(h/t to Wisconsin Office of Rural Health)

EXTRA: On Friday, March 20th from 3-4pm Dr. Daryl Thornton will be presenting the next lecture in our Works in Progress series. The topic is, "Interpreters as Advocates". This is a very unique project taking place at MetroHealth Medical Center.

Location is room R240 of the Rammelkamp building at MetroHealth Medical Center.

Please RSVP to Michele Abraham at or by phone at 216-778-3858.

Posted by: Staff on March 18, 2009
Category: Access to Health Care; Disparities; Health Care; Health Disparities; Health Inequities; Hospitals; Patient Navigators; Works in Progress; emergency care; health care access

March 17, 2009

links for 2009-03-17

Posted by: Staff on March 17, 2009
Category: Lunch Break Reading

March 16, 2009

links for 2009-03-16

Posted by: Staff on March 16, 2009
Category: Lunch Break Reading

March 13, 2009

links for 2009-03-13

  • A new report by an independent watchdog group says inmates in New York State's 70 prisons lack adequate access to health care.
  • High blood pressure accounts for some of the disproportionately higher mortality rates among African American women with breast cancer compared with their Caucasian counterparts, according to an article in the International Journal of Cancer.
  • Restaurant group to challenge ruling that businesses with 20 more more employees have to offer health benefits.
  • With Inuit women three times more likely to die from cervical cancer than other Canadian women, it is clear that there is a vast health discrepancy here.
  • While the doctors were aware that dying patients might feel abandoned and even took what they believed were steps to prevent it, patients and their caregivers continued to feel abandoned by their doctors both in the period leading up to and at the time of death.

Posted by: Staff on March 13, 2009
Category: Lunch Break Reading

March 12, 2009

links for 2009-03-12

Posted by: Staff on March 12, 2009
Category: Lunch Break Reading

Native American Death Rates Soar


A recent state Department of Health report showed that the march against cancer, heart disease and infant mortality has largely bypassed Native Americans. In 2006, the latest year studied, Native American men were dying at the highest rate of all people, with little change since the early '90s. Their life expectancy was 71, the lowest age of all men, and six years lower than that of white men.

The news was just as grim for Native American women. Their death rate had surged by 20 percent in a 15-year period, while the overall death rate had decreased by 17 percent.

But the starkest health disparity was among babies. Native American babies were dying at a rate 44 percent higher than a decade ago, while the overall rate of infant deaths had declined.

Posted by: Staff on March 12, 2009
Category: Access to Care; Access to Health Care; Health Care Costs; Health Disparities; Health Inequities; Native American Health; Social Determinants of Health; Socioeconomic Status

March 11, 2009

links for 2009-03-11

Posted by: Staff on March 11, 2009
Category: Lunch Break Reading

March 10, 2009

links for 2009-03-10

  • More than three-quarters of adult Americans who have health insurance say they still worry about paying more for their medical care, and nearly 50 percent say they're "very" or "extremely" worried about the issue
  • “We have to face up to the fact that individual and collective mental health and well-being depends on reducing the gap between rich and poor. A large divide leads to a mentally unhealthy society, and many associated social problems. In the UK in particular, we’ve failed to acknowledge this link, preferring instead to blame the health and social conditions of those living on or near the poverty line on their own lifestyle choices.”
  • Dangling a financial carrot in front of doctors as a way to improve health quality has changed the way some doctors practice medicine, but has yet to significantly improve quality and may be interfering with doctor-patient relationships
  • In what may be an ominous sign for retail clinics, CVS Caremark has closed about 90 of some 550 MinuteClinic locations until the next flu season or other “seasonal” needs demand their services

Posted by: Staff on March 10, 2009
Category: Lunch Break Reading

March 09, 2009

links for 2009-03-09

Posted by: Staff on March 09, 2009
Category: Lunch Break Reading

March 06, 2009

links for 2009-03-06

  • Sick or injured African-American patients wait about an hour longer than patients of other races before being transferred to an inpatient hospital bed following emergency room visits, according to a new national study published in the journal Academic Emergency Medicine
  • The study suggests that independent grocery stores can improve access to healthy foods in areas where supermarket chains choose not to venture. Having a large grocery store in the neighborhood boosted the average fruit and vegetable intake by 0.69 servings per day.
  • Physicians for a National Health Program, a group of docs that claims 15,000 members and supports a single-payer system, had planned to demonstrate outside the White House today over what they said was the exclusion of single-payer advocates from the White House’s health-reform summit. But yesterday, PNHP canceled the protest — after the group’s president was invited to today’s meeting. Rep. John Conyers (D-Mich.), who backs a Medicare-for-All bill in Congress, was also invited.
  • “Place of residence plays a larger role in dietary health than previously estimated,” said Manuel Franco, MD, PhD, lead author of the studies and an associate with the Bloomberg School’s Department of Epidemiology. “Our findings show that participants who live in neighborhoods with low healthy food availability are at an increased risk of consuming a lower quality diet. We also found that 24 percent of the black participants lived in neighborhoods with a low availability of healthy food compared with 5 percent of white participants.”

Posted by: Staff on March 06, 2009
Category: Lunch Break Reading

March 05, 2009

links for 2009-03-05

Posted by: Staff on March 05, 2009
Category: Lunch Break Reading

The problems of Latinos with diabetes

Bay State Banner has an in-depth look at many of the problems Latinos face when they are fighting diabetes. Among the issues are:

Lack of access to Spanish language health information

Cost of office visits and/or medications

Lack of access to stores that sell fresh/health food

High rates of insulin resistance in the Latino population

Unhealthy foods that are tied to culture and tradition

Lack of access to safe public areas for physical activity

EXTRA: Be sure to check out our Lunch Break Reading feed over at Delicious. Stay current with all the news around health and health disparities.

Posted by: Staff on March 05, 2009
Category: Disparities; Health Care; Health Care Costs; Health Disparities; Health Inequities; Heath Inequities; Latino; Latino; Latinos; Linguistic Competency

March 04, 2009

links for 2009-03-04

Posted by: Staff on March 04, 2009
Category: Lunch Break Reading

March 03, 2009

links for 2009-03-03

Posted by: Staff on March 03, 2009
Category: Lunch Break Reading

Cash Up Front

Increasingly hospitals are requiring patients to pay for their procedures prior to treatment.

Someone with an office appointment might be required to either pay the entire cost of the visit, their insurance co-pay, or some lesser amount as determined by a rating system.

A recent article by the Washington Post shows how one office handles the issue:

At one doctor's office, just blocks from the White House, a video screen in the waiting area tells patients that if they don't have their insurance card, the practice would be happy to "reschedule your appointment." That practice also asks that the co-pay be coughed up before the patient sees the doctor and calls patients in arrears to a window in full view -- and earshot -- of other waiting patients.

Here in Cleveland, MetroHealth Medical Center has started requiring some payment from its poorest patients as determined by a rating system.

One of the problems with the cash up front model is this rating system.

Getting rated means you must see a financial counselor prior to making an appointment with a provider. It can take up to a month for a new patient walking in off the street to schedule the appointment to be rated, complete the paperwork, schedule an appointment with a provider, and finally see the doctor.

If the patient can't wait a month they may decide to go to the emergency room. There they will be met with higher fees for seeking out emergency care for a non-emergency condition.

If they decide to wait the rating system might result in a lower fee. But one wonders how much of a barrier to treatment even a small fee might be. For Rep. Dennis Kucinich it might be too much, "Five or 10 dollars may not seem like much, but for the families being forced to pay it, it may mean they go without a meal."

Posted by: Staff on March 03, 2009
Category: Health Care; Health Disparities; Healthcare; Uninsured; cash up front; insurance; insured

March 02, 2009

links for 2009-03-02

  • Washington’s Death with Dignity Act will take effect in four days, and doctors, pharmacists and health facility administrators are scrambling to figure out exactly what the law says and how they’re going to deal with it.

Posted by: Staff on March 02, 2009
Category: Lunch Break Reading