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Maryland needs to reduce health disparities
No full textOver the last 40 years, Maryland and the entire country have seen groundbreaking advances in the fields of medicine and health care.
We have developed life-sustaining treatments for previously fatal diseases, including many types of cancer, HIV, and heart disease. Life expectancy has climbed, and infant mortality has fallen.
But these successes are not enough. They are not enough when so many of our accomplishments in health are shadowed by unacceptable disparities
Maryland seeks to close health disparities among minorities
No full textThe Maryland Health Quality and Cost Council is launching a workgroup to address health disparities among racial minorities, using tactics such as performing health screenings in barber shops.
University of Maryland School of Medicine Dean Dr. E. Albert Reece will lead the group in designing strategies and initiatives to reach minority groups. One could be the “barbershop engagement” approach, something Baltimore’s men’s health outreach program already uses
Why Black Women, Infants Lag In Birth Outcomes
No full textThe overwhelming majority of babies in the U.S. are born healthy, and their growth brings joy and comfort to their parents.
But across the country, there is a whopping disparity in birth outcomes based on race. Black women fare worse than white women in almost every aspect of reproductive health.
“Any state you look at, you see the same disparities, and race is the strongest predictor of disparities,” says Dr. Deborah Ehrenthal, of Christiana Care Health System in Delaware. “So we see higher rates of infant mortality, higher rates of preterm delivery.” Black women are about 60 percent more likely than white women to deliver babies early, and black infants are about 230 percent more likely than white infants to die before their first birthdays
National Archives Releases John Cutler Papers Online
No full textAtlanta, GA…The National Archives at Atlanta announced that on March 29, 2011, it will release online the papers of Dr. John C. Cutler. Dr. Cutler, a former employee of the U.S. Public Health Service, 1942-1967, was involved in research on Guatemalan soldiers, prisoners, and mental health patients who were exposed to the syphilis bacteria. The collection is available online [http://www.archives.gov/research/health/cdc-cutler-records] and at the National Archives at Atlanta, located at 5780 Jonesboro Road, Morrow, Georgia, 30260. This collection which consists of approximately 12,000 pages of correspondence, reports, photographs, and patient records was donated in September of 1990 to the University of Pittsburgh by Dr. Cutler. In September 2010, the University contacted the Centers for Disease Control and Prevention to request the transfer of the material to the Federal government. After examining the material, it was determined that they were Federal records and they were transferred to the National Archives at Atlanta in October, 2010
Multiple Perspectives on Tobacco Use Among Youth With Mental Health Disorders and Addictions
No full textPurpose. Youth and young adults with mental health disorders and addictions are at a high risk of becoming nicotine dependent, and at least half will die of tobacco-related diseases. In comparison to the general population, this population also faces neurobiological and psychosocial vulnerabilities. There is a critical need for community services and research targeting tobacco interventions for these individuals.
Methods. A concurrent mixed methods study was conducted by collecting data from in-depth key informant interviews, focus groups, and a survey. Qualitative key informant interviews with healthcare professionals (n = 11) and youth focus groups (n = 32) were conducted by using semi-structured questioning regarding barriers and facilitators to tobacco interventions. Content analysis was used to code transcripts and categorize themes. Survey data were also collected from 230 smokers ages 13 to 17 years (n = 62) and young adults ages 18 to 25 years (n = 40) at three community mental health centers. The survey inquired about tobacco use, motivation to quit, history of quit attempts, and treatment preferences.
Results. Five thematic categories were identified in both the adult key informant interviews and the focus groups with youth: (1) motivation to quit, (2) cessation treatment needs, (3) social influence, (4) barriers to treatment, and (5) tobacco-free policy. Among those surveyed, 44% currently smoked. Youth and young adult survey respondents who smoked were often motivated to quit, few had used proven tobacco cessation aids, but there was interest in access to nicotine replacement therapy.
Conclusion. Merged qualitative and quantitative findings support past literature regarding youth in the general population but also expand upon our knowledge of issues specific to youth and young adults with mental health disorders and addictions. Findings suggest interventions warranting further attention in community treatment settings
Differences in Smoking Behavior and Attitudes Among Puerto Rican, Dominican, and Non-Latino White Caregivers of Children With Asthma
No full textPurpose. No studies have examined the differences in smoking attitudes and behavior between Dominicans (DRs) and Puerto Ricans (PRs). Identification of pretreatment differences is important for cultural adaptation of evidenced-based smoking cessation treatments.
Design. Secondary analysis.
Setting/Intervention. Three home visits for asthma education and smoking cessation.
Subjects. Caregivers who smoke and have a child with asthma: DRs (n = 30), PRs (n = 67), and non-Latino whites (n = 128; NLWs).
Measures. Baseline assessment of psychosocial variables.
Analyses. Controlled for age, education, and acculturation.
Results. Compared with DRs, PRs were more acculturated, more nicotine dependent, less motivated and confident to quit, and identified more pros of smoking (all p < .05). Compared with NLWs, PRs were less likely to be employed, smoked fewer cigarettes per day, and had lower education, greater depressed mood, greater pros and cons of smoking, less social support, and higher child asthma morbidity (all p < .05). Compared with NLWs, DRs were less nicotine dependent, more confident to quit, and less likely to live with a smoker; reported greater cons of smoking and greater stress; and were more likely to have a household smoking ban (DRs 60% vs. NLWs 33.6%). Only 3.3% of DRs were precontemplators vs. 16.4% (PRs) and 10.9% (NLWs).
Conclusions. PRs appear to have more factors associated with risk of smoking treatment failure; DRs appear to have more protective factors. Examination of the role of these smoking attitudes as potential moderators and mediators of smoking behavior are needed to guide the cultural adaptation of evidenced-based treatments
"Food is directed to the area": African Americans' perceptions of the neighborhood nutrition environment in Pittsburgh.
No full textStudies have shown racial disparities in neighborhood access to healthy food in the United States. We used a mixed methods approach employing geographic information systems, focus groups, and a survey to examine African Americans' perceptions of the neighborhood nutrition environment in Pittsburgh. We found that African Americans perceive that supermarkets serving their community offer produce and meats of poorer quality than branches of the same supermarket serving White neighborhoods (p<0.001). Unofficial taxis or jitneys, on which many African Americans are reliant, provide access from only certain stores; people are therefore forced to patronize these stores even though they are perceived to be of poorer quality. Community-generated ideas to tackle the situation include ongoing monitoring of supermarkets serving the Black community. We conclude that stores should make every effort to be responsive to the perceptions and needs of their clients and provide an environment that enables healthy eating
Beliefs about Racism and Health among African American Women with Diabetes: A Qualitative Study.
No full textExposure to racism has been linked to poor health outcomes. Little is known about the impact of racism on diabetes outcomes. This study explored African American (AA) women's beliefs about how racism interacts with their diabetes self-management and control. Four focus groups were conducted with a convenience sample of 28 adult AA women with type 2 diabetes who were recruited from a larger quantitative study on racism and diabetes. The focus group discussions were transcribed verbatim and analyzed by the authors. Women reported that exposure to racism was a common phenomenon, and their beliefs did in fact link racism to poor health. Specifically, women reported that exposure to racism caused physiological arousal including cardiovascular and metabolic perturbations. There was consensus that physiological arousal was generally detrimental to health. Women also described limited, and in some cases maladaptive, strategies to cope with racist events including eating unhealthy food choices and portions. There was consensus that the subjective nature of perceiving racism and accompanying social prohibitions often made it impossible to address racism directly. Many women described anger in such situations, and the tendency to internalize anger and other negative emotions, only to find that the negative emotions would be reactivated repeatedly with exposure to novel racial stressors, even long after the original racist event remitted. AA women in this study believed that racism affects their diabetes self-management and control. Health beliefs can exert powerful effects on health behaviors and may provide an opportunity for health promotion interventions in diabetes
Health Disparities in New York City: Disparities in Breast, Colorectal and Cervical Cancers in New York City
No full textDisparities in Breast, Colorectal and Cervical Cancers is part of a series of reports from the Health Department that aims to inspire action by documenting current health disparities in NYC, as well as changes over time, and identifying community- and policy-based solutions to close the health gaps among New Yorkers
Community-Centered Family Health History: A Customized Approach to Increased Health Communication and Awareness
No full textBACKGROUND:
There has been little study of whether family health history (FHH) tools used by individuals, families, and communities inspire measurable changes in communication and behavior.
OBJECTIVES:
The Community-Centered Family Health History (CCFHH) project was a collaborative endeavor among national and community-based organizations with an interest in genetics education and health. Using community- based participatory research principles as a foundation, CCFHH examined whether the Does It Run In the Family? toolkit, a set of two customizable booklets on health and genetics, encourages discussion and collection of FHH information across diverse communities.
METHODS:
Five communities across the country measured the utility of customized versions of the Does It Run In the Family? toolkit. Each community partner recruited families, consisting of two or more blood relatives, to use the toolkit for 3 months, discuss it among their family members, and consider the implications of the health information. Pre- and postintervention surveys measured family communication about family history and disease risk and the use of FHH information in health care provider interactions.
RESULTS:
After aggregate, cross-community analysis of individual responses, from pre- to post-toolkit use family members showed increases in communication about family history of disease risk (p < .05) and in awareness about FHH (p < .05).
CONCLUSION:
These findings indicate that diverse communities are receptive to FHH intervention, and tailored health educational materials can lead to increased conversations and awareness about health issues across communities