kaisernetwork.org: Kaiser Health Disparities Report

Hispanics in Massachusetts Less Likely To Visit Physicians, Survey Finds

Fri, 29 May 2009 00:00:00 EST

Hispanics in Massachusetts are less likely than whites to have visited a physician in the last year, according to a survey that was funded by the Blue Cross-Blue Shield of Massachusetts Foundation, the Commonwealth Fund and the Robert Wood Johnson Foundation, the Springfield Republican reports. The survey also found that Hispanics were about twice as likely as whites to visit an emergency department for a nonemergency condition.

The survey, which was conducted last fall, included 4,041 adults ages 18 to 64 in Massachusetts. Overall, the survey found that people living in western Massachusetts had more difficulty accessing health services than people living in other areas of the state, in part because of a shortage of primary care physicians. While the survey found that nearly all state residents have health insurance, more than 25% of residents in four western counties reported that providers either would not accept their insurance or were not accepting new patients. The survey did not find significant differences across the state in the ability of residents to pay medical bills. In addition, the survey did not find any evidence that health care costs are more of a burden to Hispanics and blacks than to whites (McAuliffe, Springfield Republican, 5/28).

California-Based Desert AIDS Project To Hold Retreat Targeting Hispanics Living With HIV/AIDS

Fri, 29 May 2009 00:00:00 EST

The Palm Springs, Calif.-based Desert AIDS Project next week will hold a health and wellness retreat targeting Hispanics living with HIV/AIDS, the Desert Sun reports. The program, called Grupo Latino, will provide individual and group activities -- such as depression and anxiety workshops, yoga and meditation -- for HIV-positive people. The program aims to help HIV-positive Hispanics and their families combat stigma associated with HIV/AIDS. In addition, DAP provides health care and social services for HIV-positive people.

An estimated 5,000 to 7,000 people in California contract HIV annually. The state has one of the highest HIV rates nationwide, with more than 100,000 people living with the virus, according to the California Department of Public Health Office of AIDS (Brambila, Desert Sun, 5/27).

Efforts Call for Reducing Suicide Among Alaska Native, American Indian Youth; Provide Health Information for Asian, Pacific Islander Communities

Fri, 29 May 2009 00:00:00 EST

The following highlights efforts that seek to reduce racial and ethnic health disparities.

Alaska: Sen. Lisa Murkowski (R) on Wednesday in a letter to HHS Secretary Kathleen Sebelius requested $1.2 million to fund a study aimed at understanding the causes of suicide among Alaska Natives and American Indians and reducing the number of suicides among the groups. The study was proposed by Commissioner Warren Zapol of the U.S. Arctic Research Commission and would examine mental and behavioral health issues among Alaska Natives and American Indians. Murkowski noted that the suicide rate among these groups is 70% higher than among the U.S. population and that suicide is the second leading cause of death for American Indian and Alaska Native youth ages 10 to 24. "Suicide affects our Native communities in epidemic proportions, and we must do all we can to support our clinicians, communities and leaders to address the issue of youth suicides," Murkowski said (Murkowski release, 5/27).

Asian, Pacific Islander communities: The Asian & Pacific Islander American Forum on Thursday launched the Health Information Network to provide information and resources on health issues affecting Asian, Native Hawaiian and Pacific Islander communities. The network will provide tools for communication among advocates, policymakers and community leaders, as well as a directory of organizations serving these populations. In addition, the forum is collaborating with HHS' Office of Minority Health, the National Council of Asian Pacific Islander Physicians and the Association of Asian Pacific Community Health Organizations to provide information on public health information through the network (USAsian Wire, 5/28).

Low Vitamin D Levels in Blacks Could Contribute to Higher Rates of Cancer, Other Diseases, Researcher Says

Thu, 28 May 2009 00:00:00 EST

Low vitamin D levels in blacks could contribute to health gaps between white and black U.S. residents, Michael Holick, a professor at Boston University and a vitamin D researcher, said recently, the GNS/Chicago Sun-Times reports. According to Holick, blacks have lower levels of vitamin D than whites in part because the higher amount of pigment in their skin makes it harder for their body to absorb the nutrient, which is produced in response to sun exposure.

Although scientists are debating optimum vitamin D levels, some scientists have said that vitamin D can reduce the risk of cancer, diabetes, heart disease and other illnesses. Holick added that some scientists believe blacks are more likely to have prostate cancer, breast cancer and colon cancer and have more aggressive forms of the cancer because they have lower levels of vitamin D. John Flack, principal investigator at the Center for Urban and African American Health at Wayne State University, said lower vitamin D levels among blacks is "potentially a very important explanation for some of the differences, from hypertension to cancer to heart failure," adding, "The actual proof is not there, but it's plausible." Flack added that many factors -- including decreased access to health care and differences in income and education -- contribute to the overall poorer health among blacks.

The Institute of Medicine next year is expected to release new guidelines on recommended daily intake for vitamin D. "All Americans, but particularly people with darker skin, should pay attention" to the new guidelines, according to Adit Ginde, a researcher at the University of Colorado Denver School of Medicine who led a recent study that found vitamin D levels are decreasing in all racial groups and are particularly low in blacks (Painter, GNS/Chicago Sun-Times, 5/28).

Survey Examines Health Outcomes of American Indians in Alabama

Thu, 28 May 2009 00:00:00 EST

American Indians in Alabama have better outcomes than the rest of the state's population in some health indicators but are less healthy in other areas, according to a survey released by the Alabama Department of Public Health, the Montgomery Advertiser reports.

The report -- titled "Health Survey of American Indians of Alabama 2008: Keeping the Circle Healthy" -- surveyed 3,000 people from the nine recognized tribes in the state. The study found that overall American Indians in Alabama had lower levels of obesity than the rest of the state and nation. The report also found that American Indians exercise more and eat more fruits and vegetables than the state's general population. American Indians also reported that they smoke and binge drink less than the rest of the state. In addition, the report found lower rates of hypertension and arthritis among American Indians when compared with state and national populations.

However, the report found that American Indians in Alabama consume more alcohol and have more strokes and heart attacks than other state residents. American Indians in the state also are less likely to undergo recommended screenings, such as Pap tests, mammograms and prostate exams, the report found. The report found that a high percentage of people in the state's Piqua Shawnee and Ma-Chi's Lower Creeks tribes lack health insurance. The report also found that two tribes have the capability to monitor health trends and provide preventive care. According to the Advertiser, the Poarch Band Creek is the tribe statewide that is federally recognized and has access to health services through the Indian Health Service. In addition, one tribe -- the MOWA Band of Choctaw Indians -- is recognized by the state and has a health clinic on its reservation.

Ben Moreira, planning and economic development strategist for the Alabama Indian Affairs Commission, said American Indians represent about 1% of Alabama's population. Moreira said he hopes the report will help American Indian tribes make decisions about health care resources. "One of our primary goals is to get this survey into the hands of people who make the decisions about the allocation of health resources in the state," he said, adding, "There is also a lot of information that is tribal specific that could be used to develop programs internal to each tribe" (Ricks, Montgomery Advertiser, 5/28).

'Complacency,' 'Stigma' Hindering Efforts To Reduce HIV/AIDS in Black Communities, Opinion Piece Says

Thu, 28 May 2009 00:00:00 EST

"Nearly 30 years after the discovery of HIV and AIDS, the epidemic is still ravaging black neighborhoods in Baltimore and across the nation," Kevin Fenton -- director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention -- writes in a Baltimore Sun opinion piece. Fenton writes that "complacency about HIV and the continued stigma associated with the disease are hindering progress by preventing too many African-Americans from seeking either HIV testing and treatment or support from their friends and family," adding that "this is a challenge that can be overcome."

According to Fenton, the Obama administration last month "took an important step in confronting the United States' HIV epidemic" when CDC and White House officials announced a five-year campaign called Act Against AIDS, which is "designed to refocus the nation's attention on the HIV crisis here at home." Fenton notes that 14 black civic organizations -- including NAACP, the National Urban League, the Southern Christian Leadership Conference and the National Council of Negro Women -- are "joining the CDC to increase knowledge, awareness and action within black communities across the country." He adds that the campaign "will harness the strength and reach of these organizations by enhancing their ability to make HIV prevention a core component of their daily activities."

"By raising the visibility of HIV and AIDS, the new campaign also aims to confront and overcome the fear and stigma that help keep HIV alive in black communities," Fenton says. He adds that he has "been encouraged in recent years to see black leaders, including black faith leaders, speak out more openly across the nation about the need to confront HIV and the stigma that persists surrounding this disease." Fenton writes that "[e]nding this epidemic will require not only frank and difficult discussions about HIV but also a shared sense of responsibility and commitment," concluding, "All of us can and must be part of the solution" (Fenton, Baltimore Sun, 5/27).

1M California Residents Travel to Mexico Annually for Health Care, Study Finds

Wed, 27 May 2009 00:00:00 EST

About one million adults living in California, including 500,000 immigrants, travel to Mexico for health care each year, according to a study published Tuesday in the journal Medical Care, the San Diego Union-Tribune reports.

For the study, researchers led by Steven Wallace, associate director of the Center for Health Policy Research at the University of California-Los Angeles, analyzed data from the 2001 California Health Interview Survey, which surveyed more than 55,000 households across the state. The survey, which is conducted every two years, is funded by several agencies and groups, including the California Department of Public Health, the National Cancer Institute and the California Endowment. The new study was the first to look at people traveling to Mexico for health care.

The study found that more than 13% of Mexican immigrants and 4% of all adults living in California sought care in Mexico. According to Wallace, the number of people seeking care in Mexico likely will increase as the number of Mexican immigrants living California goes up and more people become uninsured. In addition, the study found that immigrants who had lived in California for fewer than 15 years were less likely to leave the U.S. for medical care. According to the Union-Tribune, many immigrants who have lived in the U.S. for less than 15 years are undocumented and might have a harder time re-entering the country.

The study also found:

Among immigrants, the No. 1 reason for health-related travel to Mexico was dental care, while the No. 1 reason among all other people was to purchase prescription drugs;
7% of the 464,000 non-Hispanic people who sought treatment in Mexico received medical procedures, such as surgery or treatment for cancer; and
People who lived within 15 miles of the California-Mexico border were more likely to seek health services in Mexico.

About half of the people who seek care in Mexico are immigrants from Mexico, which could challenge the perception that immigrants are placing a burden on California's health system, Wallace said. "What this helps document is that (some) immigrants are facing barriers to receiving care in the United States, and they are turning to Mexico for that care," Wallace said. He added that "it's not just immigrants facing barriers here" (Darce, San Diego Union-Tribune, 5/26).

An abstract of the study is available online.

National Marrow Donor Program Increasing Efforts To Attract Minority Donors

Wed, 27 May 2009 00:00:00 EST

The National Marrow Donor Program, a not-for-profit group that manages a national registry for potential bone marrow donors, is using social networking sites to attract donors from minority communities, the Wall Street Journal reports.

The process of finding a genetic match for a bone marrow transplant is often more difficult for minorities or people who identify themselves as multiracial because patients and donors must be genetically compatible. According to the Journal, a white patient has an 88% chance of finding a match, while the odds of most minorities finding a match can be as low as 60%. The odds of some minorities actually receiving a transplant can be as low as 20% because of other factors such as access to care in their communities, the Journal reports. About seven million U.S. residents already have signed up for the national registry -- recently renamed Be the Match -- and the program also has increased outreach to younger potential donors through social networking Web sites, such as Facebook and MySpace (Landro, Wall Street Journal, 5/27).

Black Women More Likely To Have Vitamin D Deficiency, Bacterial Vaginosis, Study Finds

Wed, 27 May 2009 00:00:00 EST

Black women are nearly three times as likely as white women to have a vitamin D deficiency, which is linked with an increased risk of the vaginal infection bacterial vaginosis, according to a study published in the June issue of the Journal of Nutrition, the New York Times reports. Black women likely have lower levels of vitamin D because the higher amount of pigment in their skin prevents the body from absorbing the vitamin.

For the study, researchers led by Lisa Bodnar, an assistant professor of epidemiology at the University of Pittsburgh, examined 209 white pregnant women and 260 black pregnant women at a Pittsburgh clinic. More than half of the women had low levels of vitamin D, the study found. Women whose vitamin D levels were 50 nanomoles or less had a 26% increased risk of BV, while women whose vitamin levels were less than 20 nanomoles had a 65% increased risk of the infection. About 52% of black women had the infection, compared with 27% of white women, the study found (Bakalar, New York Times, 5/26). The study found that 93% of women with BV had low vitamin D levels and that BV prevalence decreased as vitamin levels increased.

In addition, although black women were more likely to have BV, white women who had low levels of vitamin D were as likely to have the infection as black women. Poor diets and obesity also contributed to a vitamin deficiency. Bodnar noted that black women are less likely than white women to meet dietary recommendations for vitamin D. Bodnar recommended that women discuss their level of vitamin D with their physicians and that pregnant women take a prenatal vitamin, which typically includes vitamin D.

According to the Pittsburgh Post-Gazette, Bodnar's research team has received NIH funding to conduct a study of whether vitamin D deficiency in women increases the risk of poor birth outcomes and whether high infant mortality among blacks can be attributed to factors such as obesity (Templeton, Pittsburgh Post-Gazette, 5/23).

An abstract of the study is available online.

U.S. Bill Would Establish Survey To Collect Health Data From Native Hawaiians, Pacific Islanders

Tue, 26 May 2009 00:00:00 EST

Madeleine Bordallo, the U.S. delegate from Guam, has introduced legislation that would fund a survey to collect health data from Native Hawaiians and Pacific Islanders, the Pacific Daily News reports. The legislation would amend the Public Health Service Act to fund the survey through HHS.

Bordallo said, "Native Hawaiian and Pacific Islander communities are eager to move forward with their efforts to improve public health. This scientific survey would establish baseline health information to inform health policy and interventions so that individual and community health can be properly tracked and evaluated."

According to the Daily News, while federal agencies should be collecting data on native Hawaiians and Pacific Islanders separately from Asian-Americans, most have not done so (Limtiaco, Pacific Daily News, 5/26).

Some Black Women With Advanced Breast Cancer Opt Against Treatment, Study Finds

Tue, 26 May 2009 00:00:00 EST

A new study has found that some black women with advanced breast cancer declined treatment with chemotherapy or radiation, though researchers did not know the reason why so many of the women opted against treatment, HealthDay/Las Vegas NOW reports. For the study, researchers examined records for 107 women with cases of advanced breast cancer that were reported at one inner-city hospital between 2000 and 2006. Eighty-seven percent of the women were black, and 29% of them had breast cancer tumors that did not respond well to new, targeted treatments. Of all women, 20.5% declined chemotherapy and 26.3% opted against radiation.

Lead researcher Monica Rizzo, an assistant professor of surgery at the Division of Surgical Oncology at the Emory University School of Medicine, said the reason why the women declined treatment is not clear, adding, "We looked at marital status, as well as religious background, of those women, and unfortunately, we were not able to find any clear identifier." Researchers speculated that fear of the medical system, poverty and cultural differences might play a role.

Rizzo's group has started a community outreach program through which a nurse practitioner and social worker follow up with breast cancer patients (Reinberg, HealthDay/Las Vegas NOW, 5/22).

An abstract of the study is available online.

Health Care Reform Likely Will Not Provide Coverage to Undocumented Immigrants, Sen. Baucus Says

Fri, 22 May 2009 00:00:00 EST

Sen. Max Baucus (D-Mont.), chair of the Senate Finance Committee, on Thursday said that he supports "a version" of government-run health insurance but that such a program would not cover undocumented immigrants, the Washington Times reports. Baucus was speaking at an event sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business (Haberkorn, Washington Times, 5/22). Baucus said that health care reform likely would provide coverage to between 94% and 96% of U.S. residents but that it would be "too politically explosive" to provide coverage to undocumented residents (Young, The Hill, 5/21).

Undocumented immigrants account for between 15% and 22% of the estimated 47 million U.S. residents who lack health insurance, according to analyses by the Center for Immigration Studies and the U.S. Census Bureau. Baucus said the finance committee has not yet discussed whether federal funding to treat low-income, uninsured patients should be expanded to treat undocumented immigrants. "I don't have a good answer yet to undocumented workers," Baucus said, adding, "There will still be charity care."

According to the Dallas Morning News, some immigration advocates have said health reform efforts will not be complete if undocumented immigrants do not have coverage. Jaime Torres, president of Latinos for National Health Insurance, said, "In light of what's happening now with the flu pandemic, it's pretty clear that, for any health care system to work, it has to cover everyone residing in the United States" (Landers, Dallas Morning News, 5/22). Torres added, "It's unfortunate that Sen. Baucus and the Congress might not have the courage to include the undocumented" (Washington Times, 5/22).

A podcast and video of the press conference are available online at kff.org.

Indian Health Service Releases $500 Million in Stimulus Funding To Improve Health Care for American Indian, Alaska Native Communities

Fri, 22 May 2009 00:00:00 EST

The Indian Health Service on Wednesday announced it will release $500 million in federal economic stimulus funding to improve health care for American Indian and Alaska Native communities, Health Data Management reports. The funding includes $85 million for health information technology that aims to decrease errors and modernize administrative processes, enhance hardware and network infrastructure, integrate software and support telehealth services, according to Health Data Management.

In addition, the stimulus funding will go toward building new hospitals, purchasing medical equipment, and health facility maintenance and improvement projects (Goedert, Health Data Management, 5/20). Sen. Mark Begich (D-Alaska) noted that Alaska will receive $182.2 million in funding for 72 projects in more than 30 Alaska communities. Begich said, "This money to improve the delivery of health care across rural Alaska is greatly needed," adding, "These upgrades include emergency room renovations, ambulance bay extensions, better radiology services and a variety of other projects big and small that will help better serve Native communities throughout our state" (Tundra Drums, 5/21).

Efforts Fund Breast Cancer Services for Minorities; Seek To Address Health Disparities; Call for HIV Testing Among Asians, Pacific Islanders

Fri, 22 May 2009 00:00:00 EST

The following highlights efforts that seek to reduce racial and ethnic health disparities.

Colorado: The Colorado Minority Health Advisory Commission is holding several town-hall forums throughout the state to discuss ways to eliminate health disparities, the Colorado Springs Gazette reports. The commission, which was formed seven years ago, will award between $10 million and $12 million to Colorado communities to address health disparities, Ned Calonge, chief medical officer for the Colorado Department of Public Health and Environment, said. Anthony Young, a psychologist and chair of the commission, said there is a need for increased health education and awareness, including information on how to receive no-cost health screenings, in minority communities (Newsome, Colorado Springs Gazette, 5/15).

HIV testing: Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, called for increased HIV testing among Asian and Pacific Island communities ahead of the fifth annual National Asian & Pacific Islander HIV/AIDS Awareness Day, which took place on Tuesday. According to Fauci, public health officials and caregivers should increase efforts to communicate messages about HIV prevention to Asian and Pacific Islander communities in linguistically appropriate and culturally relevant ways. In addition, the NIH Office of AIDS Research recently published the fiscal year 2010 Trans-NIH Plan for HIV-Related Research, which contains a chapter on how to address HIV/AIDS among Asians and Pacific Islanders and other minority groups (NIH release, 5/18).

Oregon/Washington: The Oregon and Southwest Washington Affiliate of Susan G. Komen for the Cure recently awarded $2 million to organizations that support health care for American Indian, Asian, Hispanic and Russian communities in Oregon and southwest Washington to fund breast cancer research and services to medically underserved populations, the Burns Times-Herald reports. The grant also will be used to provide health care in rural areas. The initiative will provide services to more than 24,000 men and women who are experiencing language and cultural barriers, financial difficulties and transportation issues that limit their access to health care. In addition, the program will provide support services to women who are in treatment for breast cancer, as well as to breast cancer survivors (Burns Times-Herald, 5/20).

Issue Brief Examines Disparities in Unmet Dental Care Needs Among Children

Fri, 22 May 2009 00:00:00 EST

"Trends in Child Health 1997-2006: Assessing Racial/Ethnic Disparities in Unmet Dental Care Needs," Joint Center for Political and Economic Studies: The issue brief examines disparities in the reporting of unmet dental care needs because of cost over the past 12 months among black, Hispanic and white children younger than age 18. The brief compares the unmet dental care needs among the racial/ethnic groups of children overall and among children of various racial/ethnic groups in families with similar sociodemographic characteristics, such as family type, poverty status and health insurance coverage. Hispanic children are the most likely to have dental care needs that are unmet because of cost, according to the brief. In addition, the brief analyzes several indicators of child health -- including low birthweight, health status, unmet dental care needs, ADHD/ADD diagnosis and asthma diagnosis -- to provide additional details of disparities in child health (Joint Center for Political and Economic Studies, May 2009).