Monthly Archive for July 2009
July 31, 2009
links for 2009-07-31
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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.
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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
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"For the first time, we have evidence that the major difference in survival between black and white patients with head and neck cancer appears to be the rate of HPV infection. We found an astounding difference in prognosis between patients who are HPV-positive and those who are HPV-negative,"
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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.
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Alliance researchers will focus on several of the most successful approaches used to combat malnutrition and attempt to further enrich foods already used to fight it.
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
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The lack of cultural understanding between health-care providers and minority populations is a critical public health concern. As lawmakers work to reform health care, it's important that they address this problem which has long plagued America's health system.
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Researchers seek out the genetic component that causes prostate cancer.
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The number of people who went uninsured in 2008 may be over 50 million.
Posted by: Staff on July 21, 2009
Category: Lunch Break Reading
July 17, 2009
links for 2009-07-17
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Boston Medical Center filed suit yesterday against the state, accusing officials of illegally cutting payments made to the hospital for treating thousands of poor patients, a decision executives said could financially unravel the urban hospital’s key services.
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Dale H. Yamamoto says that common provider fees, a national data warehouse, and a physician council are the keys to health care reform.
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Who pays when a student-athlete gets hurt? Sometimes its the student.
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
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Disparities exist in who is obese. This study found that foreign-born black men were the least likely to be obese while U.S. black women were the most likely. Education, self-image, social stigma and other factors contributed.
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How much are we willing to spend for six more months of life?
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As unemployment rises more people are using programs that are funded at the state and federal level. The problem is, although utilization is increasing, funding isn't.
Posted by: Staff on July 16, 2009
Category: Lunch Break Reading
July 15, 2009
links for 2009-07-15
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Is donating a kidney a preexisting condition?
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Maybe health care funding shouldn't be affected by swings in the economy.
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The Boston Public Health Commission has launched a new campaign to help improve the survival rates for African-American women with breast cancer.
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U.S. business will spend 9% more for health care costs in 2010 and with rising unemployment more people will be dependent on public programs.
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A UCSF team has found that using a simple communication technology is more effective than traditional methods in managing diabetes in under-served populations that have communication barriers.
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
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Study reports that when socioeconomics, stage at diagnosis, and type of treatment were considered, race no longer predicted survival.
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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
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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.
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What happens when you forget to list hypertension as a pre-existing condition? The insurance company doesn't pay for your heart stent.
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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
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Governor says universal health care too expensive for the state.
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Women pediatric residents more likely to request and receive less money, receive lower scores.
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Hospitals in Washington are required to provide free care to anyone living below the poverty line, if they ask for it. But some hospitals give more freely than others.
Posted by: Staff on July 10, 2009
Category: Lunch Break Reading
July 09, 2009
links for 2009-07-09
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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.
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"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."
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[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
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[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.
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Racial Disparities in Breast Cancer Mortality Are Not Driven by Estrogen Receptor Status Alone (NIH)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.
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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.
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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
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McAllen [Texas], on average, now spends $14,946 on healthcare for every patient enrolled in the government's Medicare scheme, almost double the national average of $8,304 per Medicare enrollee.
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[In the UK] at least 46% of ethnic minorities are unfamiliar or not sure about the signs and symptoms of the various forms of cancer or how to reduce their cancer risk even though 61% have had a family member suffer from cancer.
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Qliance customers pay $99 to join, then a flat monthly rate of $39 to $119, depending on age and level of service. Patients can quit without notice and no one is rejected for pre-existing conditions.
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To improve the likelihood of being heard, the health-care industry has hired more than 350 former government staff and members of Congress to lobby on their behalf.
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
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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.
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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.
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How many nephrologists does the U.S. need?
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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
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The emergency room at Melrose-Wakefield Hospital is seeing more patients over the past six months. Many with behavioral problems such as depression. The local police chief says they are making frequent trips to the ER.
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Senior Medical Correspondent Elizabeth Cohen and AMA president Dr. J. James Rohack discuss health care reform.
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A two-year effort to create a countywide health program for Cuyahoga County's poor and uninsured is at risk of falling short of its ultimate goal as the group's members debate exactly how much money and other resources they are willing to commit.
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Documentaries about health-care and food are all the rage. Cue the lights - bring the music up - action.
Posted by: Staff on July 02, 2009
Category: Lunch Break Reading
July 01, 2009
links for 2009-07-01
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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.
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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.
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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