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Monthly Archive for July 2009

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July 31, 2009

links for 2009-07-31

  • Book Review in NEJM: The author argues for a "patient-centered bioethics" that pays attention to these problems and maintains a strong alliance with primary care medicine. This is, he contends, "the side of medicine most concerned about talking with and listening to patients and forging long-term relationships" with them. Brody also argues that bioethicists should talk with and listen to communities (not just patients), and in an insightful chapter, he compares and critiques several models of community dialogue.
  • Because Americans in the upper half of the income distribution devote a smaller share of their income to health care, their standards of living have yet to decline, but they, too, will do so in the coming decades if current trends continue. If health care reform based on private health insurance is to be sustainable, it has to be affordable for Americans across the entire income distribution. Achieving this goal will require both substantial cost containment and shifts in the distribution of health care costs within the population.

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

July 30, 2009

Early Screening Reduces Disparities For Prostate Cancer

According to an article cited in Medical News Today

Men who have a regular, ongoing relationship with a health care provider are more likely to receive prostate cancer screening and less likely to be diagnosed with advanced prostate cancer, regardless of their race...

For more information, see the article in Cancer.

Posted by: Staff on July 30, 2009
Category: Cancer; Cancer Screening; Disparities; Health Disparities; Prostate Cancer

links for 2009-07-30

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

July 29, 2009

Medical Homes: the new experiment in primary care

According to CBS News, select primary care physicians are taking part in enhancing the concept of a medical home.

Without more help for family doctors - health care reform could make the crisis worse. If you think it's hard to see your family doctor now - imagine what happens when 45 million uninsured American start to enter the system.

You can read the entire article and watch the news story at CBS.com

Posted by: Staff on July 29, 2009
Category: Health Care; Health Care Costs; Primary Care; medical home

July 21, 2009

links for 2009-07-21

Posted by: Staff on July 21, 2009
Category: Lunch Break Reading

July 17, 2009

links for 2009-07-17

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

Cultural Compentence in Medicine

NYTimes.com has an article posted that speaks to the need for cultural competence in medicine to reduce health disparities and improve outcomes.

The article tells the story of a Chinese family who immigrated to the U.S. fifty years ago. The mother, who was probably infected with hepatitis B, died from inoperable liver cancer. Later, two of her sons died from liver disease brought on by hepatitis B. Eventually, all the siblings learned they were infected with hepatitis B and were at risk for liver disease. They most likely contracted it from their mother during birth.

Chinese, especially those who immigrate from Fujian, are at a higher risk for contracting hepatitis B.

The author of the article had the chance to speak with one of the liver specialists who eventually cared for the family.

The siblings he cared for, I learned, were faring well. “But what a pity,” my colleague said shaking his head. “If only one of the clinicians they had seen earlier had been a little more aware of some of the health concerns of Asian-Americans.”

Over the last two decades, that awareness has been increasing. While researchers have begun to understand the profound extent to which a patient’s cultural background can influence health care, more and more medical schools and training programs have integrated what is termed “cultural competency” into their curricula. “Culture works at all levels,” said Dr. Arthur Kleinman, professor of medical anthropology and psychiatry at Harvard Medical School. “It affects health disparities, communication and interactions in the doctor-patient relationship, the illness experience and health care outcomes.”

EXTRA: The Fresh Air Fund is looking for runners and sponsors to join the Fresh Air Fund-Racers team for the NYC Half-Marathon on August 16th. This is a great way to participate in NYC's premier summer road race while helping Fresh Air Fund children. More information at their website.

Posted by: Staff on July 17, 2009
Category: Asian-American health; Health Disparities; fresh air fund; liver disease

July 16, 2009

links for 2009-07-16

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

July 15, 2009

links for 2009-07-15

Posted by: Staff on July 15, 2009
Category: Lunch Break Reading

Pink and Black Campaign

The Boston Public Health Commision has launched the Pink and Black Campaign.

Video also available at YouTube.

More information on the campaign is available at pinkandblack.org.

Posted by: Staff on July 15, 2009
Category: African-American Health; Breast Cancer; Health Disparities; Pink and Black

July 14, 2009

links for 2009-07-14

  • Study reports that when socioeconomics, stage at diagnosis, and type of treatment were considered, race no longer predicted survival.
  • The [stimulus] bill offers medical facilities as much as $64,000 per physician if they make "meaningful use" of "certified" health IT in the next year and a half, and punishes them with cuts to their Medicare reimbursements if they don’t do so by 2015. Obviously, doctors and health administrators are under pressure to act soon. But what is the meaning of "meaningful use"? And who determines which products qualify? These questions are currently the subject of bitter political wrangling.

Posted by: Staff on July 14, 2009
Category: Lunch Break Reading

July 13, 2009

links for 2009-07-13

  • The existence of health disparities between racial and ethnic groups is common knowledge among public health wonks. But the average American may find the numbers shocking: In impoverished urban areas like Harlem, one-third of black girls and two-thirds of boys who reach their 15th birthdays don't reach their 65th. That's almost triple the rate of early death among average Americans.
  • What happens when you forget to list hypertension as a pre-existing condition? The insurance company doesn't pay for your heart stent.
  • The Georgia Commission on Men's Health released its 2009 report earlier in the week. The study finds men live an average of five fewer years than women, with heart disease, stroke and cancer accounting for more than 50 percent of all male deaths in the state.

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

July 10, 2009

links for 2009-07-10

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

July 09, 2009

links for 2009-07-09

  • Black women have a lower incidence of breast cancer than white women, but once diagnosed they are more likely to die of the disease. Now, two new studies add to the debate about the roles that access to care and biology play in this disparity.
  • "The greatly elevated risk of disability among Blacks aged 55 to 74 is largely explained by differences in socioeconomic status. Reductions in Black—White health disparities require a better understanding of the mechanisms whereby lower income and education are associated with functional outcomes in older persons."
  • [In the UK] some Parkinson's disease patients are going for years without seeing a specialist doctor or nurse.

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

July 08, 2009

links for 2009-07-08

  • [One] selfless act started a chain of events that would allow not just one person to get a desperately needed kidney but eight people to get new organs to keep them alive and thriving.
  • Black women who are diagnosed with breast cancer have a higher probability of dying from the disease than white women, regardless of their estrogen receptor status, according to research from the National Cancer Institute (NCI), part of the National Institutes of Health. Differences in breast cancer mortality may reflect racial differences in access and response to innovative breast cancer treatments, as well as other biological and non-biological factors, according to the report. In addition, the researchers found that differences in outcomes in the first few years post-diagnosis make up nearly all of the disparity.
  • Published Tuesday in the Journal of the National Cancer Institute, the study found that African-Americans were more likely than others to die of three gender-related cancers -- breast, prostate and ovarian -- even when they received the same advanced care from the same doctors. The researchers say the survival disparity persisted after they controlled for factors such as education and income.
  • Community Based Participatory Research manual now available from CEAL.

Posted by: Staff on July 08, 2009
Category: Lunch Break Reading

July 07, 2009

links for 2009-07-07

Posted by: Staff on July 07, 2009
Category: Lunch Break Reading

Leading the single-payer movement

Donna Smith is an organizer for the California Nurses Association. She became an advocate for a single-payer plan after she and her husband became ill.

Video also available here.

EXTRA: For an overview of single-payer health care see this Wikipedia article.

Posted by: Staff on July 07, 2009
Category: Health Disparities; Healthcare Reform; Medicare For All; Single Payer

July 06, 2009

links for 2009-07-06

  • We hold these truths to be self-evident, that all people are created equal, that they are endowed by their Creator with certain inalienable Rights, that among these are the freedom to direct ones own Life, to provide for ones own Health and to die with dignity—that to assist in providing such rights when otherwise unattainable, health professions are instituted among people, deriving their roles solely from the consent of the people they serve.
  • A free weekend of health care, canceled in May because of worries about the spread of swine flu, has been rescheduled for July 25 and 26 at two locations in Cleveland's University Circle.
  • How many nephrologists does the U.S. need?
  • There remains a 10-12 year gap in life expectancy at birth between indigenous and non-indigenous Australians.

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

Rally to End Discrimination in Health Care

Bronx Health REACH, a community based coalition, rallied on the steps of Bronx Borough Hall on June 9th to announce the filing of a complaint with the NY State Attorney General's office.



EXTRA: There is always one more test....

Posted by: Staff on July 06, 2009
Category: Community Activism; Health Disparities; Health Equity; Health Inequality; Health Inequities

July 02, 2009

links for 2009-07-02

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

July 01, 2009

links for 2009-07-01

  • Health insurance is supposed to offer protection — both medically and financially. But as it turns out, an estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured.
  • The widespread use of expensive cancer drugs to prolong patients’ lives by just weeks or months was called into question by an article published Monday in the Journal of the National Cancer Institute.
  • The disagreement centers on a critical issue: What’s the best way to cover impoverished Americans? Is it by expanding Medicaid? Or by providing subsidies for the poor to buy private insurance on new health insurance exchanges to be created by the legislation?

Posted by: Staff on July 01, 2009
Category: Lunch Break Reading