Posts filed under ‘In the News’
There is a guest essay in today’s Democrat & Chronicle by Peter Carpino (United Way or Greater Rochester) and Brian Hetherington (Empire Justice Center) that calls upon Gov. Paterson to sign into law legislation that would, among other things, provide tax credits for homeowners for lead abatement.
Gov. Paterson: Sign lead bill; save kids from brain damage
Peter C. Carpino and Bryan Hetherington
Gov. David Paterson deserves much credit for responding quickly and forcefully to the financial crisis. However, there are other critical issues that he must address using that same firm leadership.
In the next few days, Paterson must decide whether to sign into law the Childhood Lead Poisoning Primary Prevention and Safe Housing Act of 2008. The act would identify the top 30 high-risk areas in the state, require prevention plans for those communities, increase the amount of information available to the public and offer tax credits for homeowners for lead hazard reduction.
It has taken years to get this legislation passed in both houses. The research is clear that signing the bill would mean many more New York children would succeed in school and many fewer would end up in jail. Costs for health care, criminal justice and special education would decrease an estimated $25 million a year, and tax revenues would rise.
Last month, the Minority Reporter, a weekly publication that serves the African American population in Rochester, came out with an issue that was dedicated to health care. It highlights some of the health challenges facing the city’s residents (particularly the disparities in many health indicators) and profiles some of the programs that are addressing these issues. You can see a PDF of the issue here.
The government response to the obesity crisis has taken many forms over the last several years, including banning trans-fats, removing soda and candy from schools, and requiring calories to be posted on menus. However, last month Los Angeles took perhaps the most aggressive step by banning the construction of fast food restaurants in some of the city’s poorest neighborhoods. Public control over the built environment in the name of health has many advocates, including Tulane University’s Tom Farley who visited the Medical Center to discuss this very topic, which he has termed “healthscaping,” last year. The restriction, which is coupled with incentives for new grocery stores and (healthier) restaurants to move into the neighborhoods, has ignited a debate over the line between public health and personal choice.
You can read a NY Times story about the debate over the ban here.
Two new studies of interest out today. The first links cancer rates and socioeconomic status, particularly education. Researchers associate the drop in cancer rates among well educated (people with at least 16 years of education) to better prevention/screening and declines in smoking. You can read a Reuters story on the study here.
The childhood obestiy epidemic could have a lasting legacy of a growing number of adults with diabetes. You can read a HealthDay story on the Michigan study here.
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.
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.
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.
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.