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
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
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.
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.
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
By Carrie Feibel, KUHF
AUGUST 30TH, 2014, 10:18 AM
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.”
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
By Jenny Gold
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
By 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
by 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
By Milly Dawson
HBNS Contributing Writer
A leading cause of disability, depression rates are increasing in the U.S. and under-treatment is widespread, especially among certain groups including men, the poor, the elderly and ethnic minorities, finds a new study in General Hospital Psychiatry. Continue reading
By Lois Beckett
ProPublica, Feb. 3, 2014
Chicago’s Cook County Hospital has one of the busiest trauma centers in the nation, treating about 2,000 patients a year for gunshots, stabbings and other violent injuries.
So when researchers started screening patients there for post-traumatic stress disorder in 2011, they assumed they would find cases.
By Jake Grovum, Staff Writer
New state restrictions on clinics that provide abortions could leave millions of women—many of them poor and uninsured—without easy access to cancer screenings and other basic health care services.
In recent years, abortion opponents have tried to limit abortions by barring them after a certain number of weeks and by requiring women who want to end their pregnancies to have ultrasounds. Those strategies target abortion directly.
Now abortion opponents in some states are pushing for new standards for clinics, such as requiring doctors to have admitting privileges at a nearby hospital, that may be difficult or impossible for them to meet.
Abortion rights supporters fear the new rules could force many clinics to close—a result that would make it more difficult for women to get a broad array of health care services, not just abortions.
“Every time a clinic closes, the women who would be using those clinics, it’s not as if those women stop existing,” said Kimberly Inez McGuire of the National Latina Institute for Reproductive Health, an advocacy group. “It will affect whether women can get cancer screenings, whether women can get to a provider to get their blood pressure checked.”
“Clinics that serve women who may not have insurance are literally a lifeline,” McGuire said.
Fifteen states now require clinic doctors to have hospital admitting privileges, according to the Guttmacher Institute, which supports abortion rights.
In addition, 26 states require abortion-providing clinics to meet surgical facility standards, which stipulate everything from the size of certain rooms, the types of light switches used and the width of hallways.
Supporters say such requirements are common-sense public health measures. They cite high-profile examples of poor oversight and gruesome malpractice cases, most notably the Kermit Gosnell case in Philadelphia.
“What is so wrong about having high health standards in place?” asked Alabama Rep. Mary Sue McClurkin, who sponsored legislation which includes clinic regulations and requirements for doctors that has been blocked by a federal judge. “If they would just do what was in the best interest of the patient, it would not be a problem.”
Opponents of such laws say they might close a vital health care entryway for women. In many states, the clinics offer services ranging from sexually transmitted disease testing and treatment to mammograms, Pap tests and cancer screenings.
They also offer family planning counseling and birth control services—in many cases at reduced fees for the uninsured.
In 2011 and 2012, the Guttmacher Institute conducted a survey of women receiving services at family planning centers located in communities in which there were other health care options.
About four in 10 women said they used a clinic as their exclusive health care provider in the past year. Among other reasons, the women said they preferred going to a clinic because staff there knew more about women’s health and it was easier to talk to them about sex.
The connection between the clinics, public health care programs and women’s health was further underscored by a Kaiser Family Foundation study.
The report noted that in many states, there are few providers willing to accept Medicaid or other subsidized insurance programs. In those places, the clinics are a vital, and sometimes the only, option for low-income people.
For example, in 2011 Texas blocked Planned Parenthood-affiliated health centers from receiving funds from the state’s Medicaid Women’s Health Program.
Prior to the funding cut-off, those centers were caring for nearly 50,000 patients. The program served 63 percent fewer women the year after the cuts, state data showed.
The American Congress of Obstetricians and Gynecologists has also argued that clinic closings could damage women’s health. The group blasted Texas’ new abortion law and measures under consideration in North Carolina.
Those who back the laws argue the regulations would make the clinics safer.
So far, courts haven’t bought that argument, seeing laws that could shutter clinics as potentially unconstitutionally restrictive of abortion.
Courts already have blocked physician requirements in Mississippi and Alabama. Last week, Wisconsin’s law was temporarily blocked by a federal judge and advocates are preparing to fight Texas’ law as well.
“The courts have seen right through the arguments that this is somehow supposed to protect women’s health,” said Julie Rikelman of the Center for Reproductive Rights, which is involved in the legal fights. “These laws really hurt women’s health, not help them.”
Stateline is a nonpartisan, nonprofit news service of the Pew Center on the States that provides daily reporting and analysis on trends in state policy.
On Saturday, June 22, 2013, Northwest Kidney Centers will hold its 11th annual Kidney Health Fest for African American Families, featuring free health screenings, education, entertainment and healthy food made by local celebrity chefs.
The free event runs from 9 a.m. to 2 p.m. at Van Asselt Elementary (formerly the African American Academy), 8311 Beacon Ave. S., in Seattle, on Metro bus line 106. About 750 people attended last year.
Free health screenings. From 9 a.m. to 1 p.m., participants can receive a free kidney health screening and private consultation with a doctor about the results.
The screening includes a finger stick for a blood sample, urinalysis, blood pressure and weight check. Diabetes, high blood pressure and obesity all contribute to the current epidemic of kidney disease.
Educational presentations. A health education program from 10 a.m. to noon will be hosted by Chris B. Bennett, publisher ofThe Seattle Medium newspaper and talk show host on KRIZ/KYIZ/KZIZ Radio.
Dr. Jonathan Himmelfarb, director of the Kidney Research Institute in Seattle, will be among the speakers. Himmelfarb is an international authority who can explain up-to-the-minute science in terms lay people can understand.
He will talk about the reasons why kidney disease is more common in African Americans than in Caucasians, and the latest thinking about ways to prevent and treat it.
Healthy, tasty lunch. At noon, noted local chefs will serve a free lunch. Donating their services are Jemil Johnson of Jemil’s Big Easy, Mulugeta Abate of Pan Africa, Theo Martin of Island Soul, Anthony Davis of AMD’s Catering, and Kristi Brown-Wokoma of That Brown Girl Catering.
Entertainment. The award-winning Pacific Northwest Drumline Association will kick off the day, and the energy will stay high with performances by electric fusion band Comfort Food, rapper Willa Scrilla, singers and musicians from the NAACP ACT-SO program, spoken word artists, the Liberation United Church of Christ choir, and more.
Special activities for children include an obstacle course and a visit from the Black Firefighters Association truck.
Focus on fitness. Edna Daigre from Ewajo Center, Ajene Bomani-Robertson from the Austin Foundation, and Jannine Young from Core Power Yoga will speak and get the audience moving with fitness demonstrations.
This year’s Fest is dedicated to the memory of Willie Austin, former University of Washington football player and power lifting champion. His Austin Foundation provides youth with vital access to fitness and nutrition. A regular and popular presenter at the Fest, he died unexpectedly April 24,2013.
Local churches are co-hosts, providing volunteers and encouraging attendance. They include Damascus Baptist, First AME, Freedom Church of Seattle, Goodwill Missionary Baptist, Immaculate Conception, Liberation United Church of Christ, Madison Park Church of Christ, Mt. Zion Baptist, New Beginnings Christian Fellowship, New Hope Missionary Baptist, Pentecostal Covenant Church, Southside Church of Christ, St. Mary’s, Tabernacle Missionary Baptist, and Walker Chapel AME.
Community partner organizations. More than 30 exhibitors will be on hand to share resources for healthy living.
“Everyone is welcome to attend the Fest, have fun and learn about kidney disease and healthy living – and it’s completely free!” said Dr. Bessie Young, a Seattle kidney specialist who has chaired the community organizing committee since the Fest began. “Bring your friends and family and make a day of it. People of every age can have fun while they learn how to keep their families healthy.”
One in seven American adults has kidney disease. In the African American community, the number increases four-fold. Although African Americans make up 12 percent of the U.S. population, 35 percent of individuals with kidney failure on dialysis are African American. In addition, African American men are 10 to 14 times more likely to develop kidney failure due to high blood pressure than Caucasian men in the same age group.
Participants in the Kidney Health Fest will learn how to improve their lives to avoid kidney disease. This includes:
- Treating high blood pressure and diabetes, two of the leading causes of kidney failure.
- Quitting smoking.
- Reducing added salt and processed, packaged and fast food.
- Eating healthy to avoid obesity.
- Exercising at least 30 minutes a day, five days a week.
- Avoiding the overuse of pain relievers such as ibuprofen and naproxen, which can damage kidneys.
For more information about the event or to pre-register, visit www.nwkidney.org/fest. The Twitter hashtag for the Fest is #healthfest.
In honor of National Women and Girls HIV Awareness Day the Snohomish Health District is partnering with local and federal agencies to host a free Health & Beauty Fair for Women of Color on Saturday, March 9 at Edmonds Community College, and a free HIV testing day for women on March 12.
Racial and ethnic minority women experience higher rates of obesity, cancer, diabetes and HIV. “We want to remind women that with just a few simple steps, they can make great strides in preserving their health,” said Brenda Newell, Snohomish Health District HIV/STD/VHO program manager.
Empowering women of color to make their health a priority
The Women of Color Health & Beauty is from 10 a.m. to 3 p.m. Saturday, March 9 in the Woodway Building off 204th Street, near the golf course. It features inspirational speakers, health screenings, beauty services, community health resources, and a light lunch – all free.
Free Health Screenings
- Cholesterol, diabetes and BMI Screening
- Rapid HIV testing
- Breast and cervical health resources
- Flu and whooping cough vaccinations
Free Beauty Services
- Eyebrow waxing and skin care demonstrations
- Natural hair styling tips
- Nutrition and exercise resources, plus a Zumba class
This event is sponsored by AIDS Project Snohomish County, Edmonds Community College, Medical Reserve Corps, Molina Health Care, Office of Women’s Health – Region X, Snohomish Health District Verdant Health and the YWCA. For more information on the event, visit www.snohd.org/events.
In honor of National Women and Girls HIV Awareness Day, all women ages 14+ who have had any risk for HIV transmission qualify for free, rapid HIV testing on March 12.
The test involves a simple pin-prick to the finger, resulting in a tiny drop of blood, and only takes 30 minutes – including results.
No appointment is necessary, just stop by between 9 a.m. and 7 p.m. Tuesday, March 12 at Snohomish Health District Suite 106, 3020 Rucker Avenue, Everett. For more information, call 425.339.5298 or visit www.womenshealth.gov.
By Valerie DeBenedette
HBNS Contributing Writer
Low-income Americans are more likely to be satisfied with the care they receive at federally qualified health centers (FQHC) than at mainstream health care providers, reveals a new study in the Journal of Health Care for the Poor and Underserved.
The level of satisfaction shown by people who use the health centers was surprising, said lead author Leiyu Shi, DrPH, MBA, MPA, professor at the Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, M.D.
Because the centers treat a more vulnerable population, they often have a more difficult time addressing their patients’ needs, he noted. Yet, the study shows that health centers appear to be reducing gaps in both quality of service and accessibility, he said.
Federally funded health centers are usually located in medically underserved communities, making them more likely to be either in inner city or rural areas, explained Shi.
Patients using these centers are more racially and ethnically diverse than the national population and more likely to be uninsured (39 percent compared to 17 percent) or to receive Medicare or Medicaid (54 percent compared to 27 percent) and to be in fair to poor health than the general population.
But patients at FQHCs also reported better access to primary care and were more likely to be satisfied with the care they received (97.7 percent) than low-income Americans getting health care elsewhere (87.2 percent).
Patients at FQHCs also reported better access to primary care and were more likely to be satisfied with the care they received (97.7 percent) than low-income Americans getting health care elsewhere.
Federally qualified health centers have become like other health providers, but are more focused on primary care and preventive medicine, he noted.
They are based in the community, with one federal requirement being that 51 percent of the members of their board of directors be from the community. They can bill private health insurance, Medicare and Medicaid, he said.
“They have a range of ways for the completely uninsured to pay, usually on sliding fee scale,” he added. “They are much more sensitive to the individual who does not have any money or the ability to pay it back.”
Study authors suggest that there should be broader adoption of the FQHC model of care, which includes comprehensive and preventive primary care, a focus on vulnerable populations such as minorities and the uninsured, consumer participation, and cultural and linguistic sensitivity, among other features.
Shi L, LeBrun-Harris LA, Daly CA, et al.: Reducing disparities in access to primary care and patient satisfaction with care: The role of health centers. J Health Care Poor Underserved. 24 (2013): 56–66
Reach CFAH’s Health Behavior News Service at (202) 387-2829 or email@example.com
<strong><em><a title=”HBNS” href=”http://www.cfah.org/hbns/index.cfm” target=”_blank”>Health Behavior News Service</a> is part of the </em></strong><strong><em><a title=”Center for Advancing Health” href=”http://www.cfah.org/index.cfm” target=”_blank”>Center for Advancing Health</a></em></strong></p>
<strong>The Health Behavior News Service disseminates news stories on the latest findings from peer-reviewed research journals. HBNS covers both new studies and systematic reviews of studies on (1) the effects of behavior on health, (2) health disparities data and (3) patient engagement research. The goal of HBNS stories is to present the facts for readers to understand and use for themselves to make informed choices about health and health care.</strong>
Across all groups, the percentage of mothers who start and continue breastfeeding is rising, according to a report released today by the Centers for Disease Control and Prevention (CDC). The report appears in the current issue of the CDC’s publication MMWR.
According to the report, from 2000 to 2008, mothers who started breastfeeding increased more than 4 percentage points.
During that same time, the number of mothers still breastfeeding at six months jumped nearly 10 percentage points, from 35 percent in 2000 to nearly 45 percent in 2008.
In addition to increases among all groups, gaps in breastfeeding rates between African American and white mothers are narrowing. The gap narrowed from 24 percentage points in 2000 to 16 percentage points in 2008.
To learn more read the full MMWR report here.
Among infants born in 2008, 74.6% began breastfeeding, 44.4% breastfed for 6 months, and 23.4% for 12 months. Yet, there are racial and ethnic differences in breastfeeding initiation (starting) and duration (continuing) rates.
More Women Are Breastfeeding and for Longer Periods
- From 2000–2008, the percentage of women who initiated breastfeeding went up from 47.4% to 58.9% for blacks, and 71.8% to 75.2% for whites. Initiation rates for Hispanics went from 77.6% to 80.0%, although this was not a significant increase.
- Infants that were breastfed at 6 and 12 months increased greatly among all three racial/ethnic groups.
- While 74.6% of infants born in 2008 began breastfeeding, only 23.4% met the recommended breastfeeding duration of 12 months. This indicates women may need more support to continue breastfeeding.
Breastfeeding Among Black Women
- The gap between black and white breastfeeding initiation rates narrowed from 24 percentage points in 2000 to 16 percentage points in 2008. The 6-month duration gap also narrowed from 21 percentage points to 17 percentage points during that same time.
- Black infants consistently had the lowest rates of breastfeeding initiation and duration across all study years. Black mothers may need more, targeted support to start and continue breastfeeding.
Learn more about how to support breastfeeding women in various settings at the CDC’s Breastfeeding Web site.
African Americans are disproportionately affected by HIV. The Centers for Disease Control and Prevention (CDC) estimates that they accounted for nearly half (44%) of all new infections in 2010, despite making up only 14% of the population. This represents a rate that is eight times as high as that of whites.
Most of these infections are in African American men, most of whom are men who have sex with men (MSM). Young black MSM, in fact, account for more new infections than any other subgroup by race/ethnicity, age, and sex.
While African American women also continue to be far more affected by HIV than women of other races/ethnicities, recent data show early signs of an encouraging decrease in new HIV infections. CDC is cautiously optimistic that this is the beginning of a longer-term trend.
Today, we have many more opportunities than ever before to reduce the burden of HIV that African American men, women, and young adults bear. Working together with state and local public health agencies, African American communities, and other partners in the public and private sectors, CDC continues to address the HIV epidemic in African American communities.
One of these efforts is National Black HIV/AIDS Awareness Day, directed, planned, and organized by a group of organizations that partner with CDC to mobilize communities across the country to fight HIV and lessen its impact on African American communities.
National Black HIV/AIDS Awareness Day was started 13 years ago to mobilize people in African American communities to
- Get educated about the basic facts on HIV and AIDS.
- Get tested for HIV. Knowing your status saves lives!
- Get involved to raise HIV awareness and fight stigma about HIV.
- Get treated if living with HIV or newly diagnosed.
The theme for 2013, I Am My Brother’s/Sister’s Keeper: Fight HIV/AIDS, emphasizes that all African Americans, regardless of sexual orientation, economic class, or educational level, can be an important part of the solution to the HIV epidemic in African American communities.
Why Do African Americans Face a Higher Risk of HIV Infection?
Research shows that African Americans do not engage in riskier behavior than members of other racial/ethnic groups. However, there are many social and economic barriers that can increase the risk of HIV.
- The higher the proportion of people living with HIV in a community, the greater the risk with each new sexual encounter of having a sexual partner who has HIV.
- Higher rates of other sexually transmitted infections can increase the chance of getting and spreading HIV.
- Social and economic realities—such as poverty, racial discrimination, limited access to health care and housing, and incarceration—are associated with increased risk of HIV.
- Stigma, fear, and silence can increase the risk of HIV while decreasing the willingness to get support, get tested, and get treatment, if needed.
What Can You Do?
- Learn about HIV and AIDS. Educate yourself, friends, and family about HIV and AIDS and what you can do to protect yourself.
- Get tested for HIV. To find a testing site near you, call 1-800-CDC-INFO (232-4636), visit theNational HIV and STD Testing Resources website, or, on your cell phone, text your ZIP code to KNOW IT (566948).
- Speak out against stigma, homophobia, racism, and other forms of discrimination associated with HIV and AIDS.
- Donate time to HIV and AIDS organizations that work in African American communities.
What Can Community Organizations Do?
- Promote National Black HIV/AIDS Awareness Day (NBHAAD) within your business, church, or other organization, by downloading the NBHAAD toolkit. HIV awareness and testing events can provide important information that people can use to protect their health and the health of their loved ones, and to get involved.
- Educate your organization about HIV and AIDS and encourage staff and members to get involved in NBHAAD activities.
- National Black HIV/AIDS Awareness Day website
- CDC: HIV Among African Americans
Information and resources on HIV and AIDS in African American communities.
- CDC: Basic Information about HIV and AIDS
Learn about HIV and AIDS, how it is and is not transmitted, the risk factors for HIV transmission, preventing transmission, and the symptoms of HIV infection.
- HIV Among African Americans [VIDEO – 1:01]
- Factors Driving the HIV Epidemic [VIDEO – 2:43]
- HIV Among African American Women [VIDEO – 1:12]
- Act Against AIDS campaign
- Testing Makes Us Stronger campaign
- Take Charge. Take the Test. campaign
- Let’s Stop HIV Together campaign