Category Archives: African American Health

Worlds Apart: Vast disparities in treatment separate Americans with HIV

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Loren Jones, 63, lives in a government-subsidized studio apartment in downtown Berkeley. (Heidi de Marco/KHN)

Loren Jones, 63, lives in a government-subsidized studio apartment in downtown Berkeley. (Heidi de Marco/KHN)

By Barbara Feder Ostrov

A major insurer said recently it would offer life insurance to HIV-positive people because of their rising life expectancies, prompting cheers from AIDS activists.

But on the very same day,  the nation’s top disease control official described an America falling far short in its fight against AIDS.

Compared to white men, African American men were more than seven times and Latino men were almost twice as likely to die from HIV-related complications.

It might seem a jarring disconnect — but it reflects very different realities dividing the estimated 1.2 million Americans living with the human immunodeficiency virus that causes AIDS.

While life expectancies are approaching the national norm among white, affluent gay men, about 66 percent of the 1.2 million people living with HIV/AIDS in the United States are not in treatment, imperiling their health and putting them at risk for infecting others.

African-Americans, mostly gay or bisexual men, account for nearly half of the approximately 45,000 Americans infected with HIV each year.

Both African-Americans and Latinos are less likely to remain in treatment than whites.

Compared to white men, African American men were more than seven times and Latino men were almost twice as likely to die from HIV-related complications.

HIV/AIDS activists and physicians say that despite the significant medical advances in treating the disease, many patients are being left behind because of their life circumstances.

Groups that once held angry demonstrations against government agencies and pharmaceutical companies to speed access to affordable, life-saving HIV medications now emphasize the socioeconomic barriers that keep some people living with HIV from consistently obtaining and using those drugs to remain healthy.

“There is an extreme disparity when it comes to treating HIV and AIDS,” said Anthony Hayes, managing director of public affairs and policy for GMHC, formerly Gay Men’s Health Crisis. Continue reading

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Diversity in medical research is a long way off, study shows | University of California – San Francisco

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Photo courtesy of Sanja Gjenero

Despite Congressional mandates aimed at diversifying clinical research, little has changed in the last 30 years in both the numbers of studies that include minorities and the diversity of scientists being funded, according to a new analysis by researchers at UC San Francisco.

That lack of diversity could have a serious impact on our ability to care for the nearly 40 percent of the current U.S. population whose heritage includes non-European races, the authors said, and will increase in urgency as the proportion of minority residents exceeds 50 percent in 2044.

The commentary, which was published Dec. 15, 2015, in the Policy Forum of online scientific journal PLoS Medicine, compiled 30 years of raw data on funding for research by non-White scientists, as well as two decades of analyses from the National Institutes of Health (NIH) and others regarding the percentage of clinical studies that include racial and ethnic minorities.

They found that since the 1993 NIH Revitalization Act, which required all federally funded clinical research to prioritize the inclusion of women and minorities, less than 2 percent of the 10,000-plus cancer studies have included enough minorities to be relevant, and less than 5 percent of respiratory studies have.

Photo courtesy of Sanja Gjenero

Source: Diversity in medical research is a long way off, study shows | EurekAlert! Science News

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Fewer black men applying to medical school than in 1978

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Jeffrey Okonye, left, and Oviea Akpotaire are both fourth-year medical students at the University of Texas, Southwestern. (Photo by Lauren Silverman/KERA)

By Lauren Silverman
KERA

Oviea Akpotaire and Jeffrey Okonye put in long days working with patients at the veterans’ hospital in south Dallas as fourth-year medical students at the University of Texas Southwestern.

542 black male students enrolled in 1978, compared to 515 in med school in 2014.

In a class of 237 people, they are two of only five black men.

“I knew the ones above us, below us,” Okonye says. “We all kind of know each other. It’s comforting to see another person that looks like you.”

While more black men than before have graduated from college over the past few decades, the number applying to med school has dropped: From 1,410 in 1978 to 1,337 in 2014.

Enrollment statistics are similar:  542 black male students enrolled in 1978, compared to 515 in med school in 2014. Continue reading

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Surrounded by poverty, urban hospitals reach out

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By Michael Ollove
Stateline

Johns_Hopkins_HospitalJohns Hopkins University and the Hopkins health system said the upheaval in Baltimore last April, which revealed the depths of economic misery in the city, lent urgency to the major jobs, contracting and purchasing initiative they announced last month. Other hospitals around the country have also launched anti-poverty efforts. 

BALTIMORE—As a child, Bishop Douglas Miles heard the warnings about vans trolling East Baltimore streets, snatching up young African-Americans for medical experiments at nearby Johns Hopkins Hospital.

Whether there was any truth behind those stories—Hopkins has always denied them—hardly mattered. The mythology lived on and, combined with the hospital’s very real development decisions, contributed to a persistent view of Hopkins as an imperious, menacing presence amid the largely poor and African-American neighborhoods surrounding it.

“Hopkins was viewed with a great deal of suspicion and anger,” said Miles, who graduated from the school in 1970 and is the bishop of Koinonia Baptist Church in northeast Baltimore.

But now, Miles says, that perception could be changing. Johns Hopkins University and the Hopkins hospital and health system have launched an ambitious initiative to fill many more jobs with residents from distressed Baltimore neighborhoods, boost the use of minority contractors and vendors from those areas, and require their partners to follow their lead. Continue reading

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Obama administration will target hard-to-reach uninsured in next enrollment period

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ACA health reform logoBy Mary Agnes Carey
KHN

The health law’s upcoming enrollment period may be its toughest yet, with federal officials promising a vigorous outreach campaign to enroll millions of eligible yet hard-to-reach Americans who have yet to sign up for health insurance.

“Those who are still uninsured are going to be a bigger challenge,” Department of Health and Human Services Secretary Sylvia Mathews Burwell said Tuesday in remarks to the Howard University College of Medicine.

This year’s enrollment campaign will be harder in part because officials will be pursuing those who have declined to sign up for health insurance during the two previous enrollment seasons.  Continue reading

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Diabetes in the US population

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Glucometer showing a blood sugar of 105From the National Institutes of Health 

Diabetes is a disorder in how the body uses glucose, a sugar that serves as the body’s fuel. In type 1 diabetes, the body doesn’t make insulin, a hormone that triggers cells throughout the body to take up glucose from blood.

In type 2 diabetes—the most common type—the body doesn’t make or use insulin well. Both types can lead to heart, kidney, nerve, and eye diseases over time.

Hispanic Americans had the highest prevalence of diabetes at 19-23%, with up to 49% of that undiagnosed. About 21-22% of non-Hispanic black adults had diabetes, with up to 37% undiagnosed.

Non-Hispanic whites had the lowest prevalence of diabetes at 10-11%.

To assess how common diabetes is, researchers at NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) analyzed data collected in CDC’s National Health and Nutrition Examination Survey (NHANES). NHANES is a periodic survey of a representative sample of the U.S. population.

Recent surveys included blood tests and other measurements. The researchers, led by Drs. Andy Menke and Catherine Cowie, examined data gathered from almost 2,800 people during the 2011-2012 survey cycle. The study was published on September 8, 2015, in the Journal of the American Medical Association.

Continue reading

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Longevity and health in later life vary greatly by community in L.A.

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3-D Perspective image of the Los Angeles Basin from the Landsat satellite using NASA's Shuttle Radar Topography Mission (SRTM) for topography information. The vertical scale is exaggerated one and half times.

3-D Perspective image of the Los Angeles Basin from the Landsat satellite using NASA’s Shuttle Radar Topography Mission (SRTM) for topography information. The vertical scale is exaggerated one and half times.

By Anna Gorman
KHN

report on aging in Los Angeles County, the nation’s largest county and one of its most diverse, shows wide disparities in life expectancy among different ethnic groups and neighborhoods.

Overall, the life expectancy for Los Angeles County residents was about 82 years in 2011, up from nearly 76 in 1991, according to the report by University of Southern California’s Roybal Institute on Aging. Much of that can be attributed to drops in coronary heart disease, strokes and lung cancer, the report noted.

But African Americans can expect to live to an average of about 76 years whereas the average for Asians and Pacific Islanders approaches 86 years, the report said.

And residents who have reached the age of 50 in the more affluent western part of the county are expected to live about five years longer than those in largely poor South Los Angeles.

Similarly, researchers found stark differences among ethnic groups when it comes to chronic disease. Latinos in L.A. County aged 50 or older have nearly double the rate of diabetes as whites, and older African Americans have a much higher rate of hypertension than other ethnic groups. Continue reading

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Racial gap in attitudes toward hospice care

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By Sarah Varney

BUFFALO — Twice already Narseary and Vernal Harris have watched a son die. The first time — Paul, at age 26 — was agonizing and frenzied, his body tethered to a machine meant to keep him alive as his incurable sickle cell disease progressed.

When the same illness ravaged Solomon, at age 33, the Harrises reluctantly turned to hospice in the hope that his last days might somehow be less harrowing than his brother’s.

Their expectations were low. “They take your money,” Mrs. Harris said, describing what she had heard of hospice. “Your loved ones don’t see you anymore. You just go there and die.” Continue reading

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How Obamacare went south in Mississippi

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Flag_of_Mississippi.svg

In the country’s unhealthiest state, the failure of Obamacare is a group effort.

By Sarah Varney
KHN / October 29, 2014

The lunch rush at Tom’s on Main in Yazoo City, Mississippi, had come to a close, and the waitresses, having cleared away plates of shrimp and cheese grits, seasoned turnip greens and pitchers of sweet tea, were retreating to the counter to cash out and count their tips.

It didn’t take long: The $6.95 lunchtime specials didn’t land them much, and the job certainly didn’t come with benefits like health insurance. For waitress Wylene Gary, 54, being uninsured was unnerving, but she didn’t try to buy coverage on her own until the Affordable Care Act forced her to. She didn’t want to be a lawbreaker.

Months earlier, she had gone online to the federal government’s new website, signed up and paid her first monthly premium of $129. But when her new insurance card arrived in the mail, she was flabbergasted.

“It said, $6,000 deductible and 40 percent co-pay,” Gary told me at the check-out counter, her timid drawl giving way to strident dismay. Confused, she called to speak to a representative for the insurer Magnolia Health. “’You tellin’ me if I get a hospital bill for $100,000, I gotta pay $40,000?’ And she said, ‘Yes, ma’am.’”

Never mind that the Magnolia worker was wrong — her out-of-pocket costs were legally capped at $6,350. Gary figured with a hospital bill that high, she would have to file for bankruptcy anyway. So really, she thought, what was the point?

“This ain’t worth a tooth,” she said.

She canceled her coverage.

The first year of the Affordable Care Act in Mississippi was, by almost every measure, an unmitigated disaster. In a state stricken by diabetes, heart disease, obesity and the highest infant mortality rate in the nation, President Barack Obama’s landmark health care law has barely registered, leaving the country’s poorest and perhaps most segregated state trapped in a severe and intractable health care crisis. Continue reading

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Medicaid ADHD treatment under scrutiny

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Amid national concerns that too many children are being medicated for Attention Deficit Hyperactivity Disorder (ADHD), some state Medicaid programs are stepping up oversight of diagnoses and treatments.

By Christine Vestal
Stateline

ATLANTA – Attention Deficit Hyperactivity Disorder, or ADHD, affects one in every seven school-aged children in the U.S., and between 2003 and 2011 the number of children diagnosed with the condition rose by more than 40 percent.

Doctors have considerable leeway in deciding the best course of treatment for a child with the condition, no matter who is paying the bill.

But children covered by Medicaid, the joint federal-state health care program for the poor, are at least 50 percent more likely to be diagnosed with the disorder.

Children covered by Medicaid are at least 50 percent more likely to be diagnosed with the disorder.

Georgia alone spends $28 million to $33 million annually on these treatments out of its $2.5 billion Medicaid budget, according to the Barton Child Law and Policy Center here at Emory University.

That is partly because of the toll poverty takes on kids and a lack of resources in poorer schools. But some states believe there are other factors at work.

Several have begun to investigate whether doctors and mental health providers who bill Medicaid for ADHD are rigorously using evidence-based guidelines when diagnosing and treating it.

ADD by state

In Georgia, state Medicaid officials are working with the Centers for Disease Control and Prevention to improve the accuracy of diagnoses and the efficacy of treatments for the ailment.

Missouri and Vermont have also sought the CDC’s help in analyzing Medicaid claims data to determine how best to improve care for what has become the most commonly diagnosed childhood behavioral disorder. Continue reading

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Federal judge blocks Texas restriction on abortion clinics

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200px-Flag-map_of_TexasBy Carrie Feibel, KUHF
AUGUST 30TH, 2014, 10:18 AM

This story is part of a partnership that includes Houston Public MediaNPR and Kaiser Health News.

In a highly anticipated ruling, a federal judge in Austin struck down part of a Texas law that would have required all abortion clinics in the state to meet the same standards as outpatient surgical centers.

The regulation, which was set to go into effect Monday, would have shuttered about a dozen abortion clinics, leaving only eight places in Texas to get a legal abortion — all in major cities.

. . . state’s regulation was unconstitutional and would have placed an undue burden on women, particularly on poor and rural women.”

The regulation, which was set to go into effect Monday, would have shuttered about a dozen abortion clinics, leaving only eight places in Texas to get a legal abortion — all in major cities.

Judge Lee Yeakel ruled late Friday afternoon that the state’s regulation was unconstitutional and would have placed an undue burden on women, particularly on poor and rural women living in west Texas and the Rio Grande Valley. Continue reading

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Jails house 10 times more mentally ill than state hospitals, report

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Screen Shot 2014-04-08 at 7.26.27 AMBy Jenny Gold
KHN

April 8, 2014 – In 44 states and the District of Columbia, at least one prison or jail holds more people with serious mental illnesses than the largest state psychiatric hospital, according to a report released Tuesday by the Treatment Advocacy Center and the National Sheriffs’ Association. Continue reading

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How states are tackling ‘health disparities’

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Question Q&ABy Michael Ollove
Stateline Staff Writer

African-Americans are more likely to suffer heart disease and diabetes than whites. The cancer death rate for men is a good deal higher than it is for women.

American Indians and Alaska Natives are more likely to smoke tobacco than Hispanics, blacks or whites.

And Native Hawaiian adults are less likely to exercise than other ethnic groups.

These differences are called “health disparities,” and in the last two decades, the federal government and the states have focused on eliminating them. Continue reading

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Why hospitals are failing civilians who get PTSD

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Gunby Lois Beckett
ProPublica, March 4, 2014

More than 20 percent of civilians with traumatic injuries may develop PTSD. Trauma surgeons explain why many hospitals aren’t doing anything about it.

Undiagnosed post-traumatic stress disorder is having a major impact on injured civilians, particularly those with violent injuries, as Propublica detailed last month.

One national study of patients with traumatic injuries found that more than 20 percent of them developed PTSD.

But many hospitals still have no systematic approach to identifying patients with PTSD or helping them get treatment.

We surveyed 21 top-level trauma centers in cities with high rates of violence. The results show that trauma surgeons across the country see PTSD as a serious problem.  Continue reading

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