Rochester’s New Lead Law

Dr Katrina Smith Korfmacher recently published an article in the Journal of Public Health Management and Practice  on Rochester’s Lead Law and the Coalition to Prevent Lead Poisoning.

Abstract:  In December 2005, the City Council of Rochester, New York, passed an amendment to its municipal code requiring inspection for and correction of lead hazards. Local lead-poisoning prevention advocates had long recognized the need for stronger lead policy to address Rochester’s high rate of childhood lead poisoning. Between 2000 and 2005, a diverse coalition of educators, healthcare professionals, community members, researchers, government officials, and many others worked to develop a strategy for ending childhood lead poisoning in Rochester by 2010. Their experience in defining the issue, mustering resources, and structuring their decision-making processes is informative for other communities seeking to overcome barriers to improved primary prevention policy.

 

Health Disparities in Rochester: What Needs to be Done

In a follow-up to the previous post (Report Details Disparities in Care), Nancy Bennett, M.D. and Wade Norwood have written a piece that appeared in today’s Democrat & Chronicle. Bennett is director of the URMC Center for Community Health and Norwood is director of Community Engagement for the Finger Lakes Health Systems Agency.

The piece (which appears below) addresses the underlying factors behind disparities in our community, the progress that has been made, and the challenges that remain.

Spread good health to all corners of Rochester

Dr. Nancy Bennett and Wade Norwood

In the World Health Organization’s comparison of the health of nations, the United States ranks 24th, below most industrialized nations. However, the United States spends more per capita, and our expenditures are rising faster than those in any other country. While the reasons for this paradox are many, one critical factor is the persistence of health disparities based on race, ethnicity and socioeconomic status.

To improve our country’s health, we must improve the health of our most vulnerable populations. While we all are cared for by the same health systems, white suburban populations enjoy relatively good health, but poor urban and rural populations do not.

One example of these horrible inequalities was reported this month by the Dartmouth Atlas Project: African Americans are more likely to suffer leg amputations than white people.

The reasons for such differences are complex.

• African Americans have higher rates of obesity and smoking, putting them at greater risk for diabetes and peripheral vascular disease, heightening the risk of amputation.
• African Americans are likely to have poorer access to primary and specialty care, which might improve the management of chronic disease, thus preventing complications.
• African Americans often have poorer access to advanced surgical alternatives to amputation.

Although these differences may be related to the adequacy of insurance, studies have shown that differences remain even when coverage is equal. We need to understand, through public health and health services research, the complexities of this pathway so that we can eliminate inequalities.

Report Details Racial Disparities in Care

The Dartmouth Atlas Project has released a report titled Disparities in Health and Health Care Among Medicare Beneficiaries.  While disparities in care are generally associated with race and socioeconomic factors, the Dartmouth report reveals that geography also plays an important role.  The report examines geographic disparities in the rates of leg amputations (a complication of diabetes), screening for breast cancer and diabetes, the prevalence of primary care physicians, and ambulatory care vs. hospitalization rates. You can read a NY Times article on the report here.

The Robert Wood Johnson Foundation used the data in the report as a platform to announce $300 million in new grants to fight health disparities.

The Democrat and Chronicle reports on the Rochester numbers in the report (full article after the jump) and notes that that while progress has been made in areas such as immunizations and mammograms, disparities in diabetes care remain.  According to the most recent Monroe County Adult Health Survey, 20 percent of African Americans in the county have diabetes – more than twice the number of whites and Latinos.

CDC Survey Details Teen Behavior

The Centers for Disease Control and Prevention has released its 2007 Youth Risk Behavior Survey. The news is decidedly mixed. The number of teens smoking, drinking, and having sex is down, but risky behavior (drug and alcohol use and attempted suicides) remains high among Hispanics. This is of particular concern as Hispanics are one of the fastest growing populations.

The survey also shows that efforts to convince teens to delay or practice safe sex appear to be faltering. After several years of declines, the sexual behavior rates have leveled off and there is evidence that rates of teen sex may be going up while condom use may be on the decline.

You can find the CDC report and additional data here. You can read articles about the study in USA Today here, the Washington Post here, Reuters here, and the Associated Press here.