Behind The Healthcare Reform Act
The Latino Journal E-News, August 24, 2009
Part 3 of 3
The America's Affordable Health Choices Act is a 1017 page proposed legislation that is requiring Legislators to attend workshops so they can learn what it does. Although the Act would not be implemented until 2013, it is a necessity and beneficial to Latinos. As mentioned we have been looking at the pros and cons of this legislation and in this issue we present the pros from a Latino perspective:
Provisions of the Healthcare Act:
1. Coverage and Choice
The Act says it will protect current coverage and allow individuals to keep the insurance they have if they like it - and preserves choice of doctors, hospitals, and health plans. Each year thousands of individuals and families are denied coverage by insurance companies, contributing greatly to the 45 million who are not or can not be insured in America today. The act will ensure that those who are not or cannot be covered, will be covered, regardless of pre-existing medical conditions. If an individual already has insurance, there will be no change.
2. Affordability
It will cap annual out-of-pocket spending, create competition among healthcare insurance providers, expands Medicaid, and improves Medicare. This Act will make insurances more affordable by creating competition, something the insurance companies have been fighting because that would cut into their price fixing. It would reduce the paperwork and patients will have a good understanding of what will and will not be covered.
3. Shared Responsibility
The bill creates shared responsibility among individuals, employers and government to ensure that all Americans have affordable coverage of essential health benefits. By spreading the costs among all groups, it will minimize the cost of providing healthcare to all Americans. In addition it will ensure that rate increases are discussed and commensurate with cost of living increases. It will especially help small businesses who currently are unable to cover their employees.
4. Prevention and Wellness
This includes a focus on community based program and new data collection to better identify and address racial, ethnic, regional and other health disparities and funds to strengthen state, local, tribal and territorial public health departments and programs. This is crucial for providing appropriate healthcare for everyone. Understanding cancer clusters, cultural habits and even indigenous beliefs are essential to understand and prescribe effective treatment. Finally, it would create opportunities to minimize if not erradicate certain illnesses among ethnic groups.
5. Workforce Investments
It will expand health care workforce and expand scholarships and loans for individuals in needed professions and shortage areas. This would include training of nurses to work in triage environments, and expand the recruitment and employment of Latinos in the medical and pharmaceudical fields. It will expand coverage into rural areas which are in dire need of medical professionals. Poor and farm worker Latinos would greatly benefit from this effort.
6. Controlling Costs
The bill will reduce the growth in health care spending as it is implemented. Healthcare spending has been under private insurance control, which has allowed to become unaffordable. By establishing a medical board, controls will be instilled in pricing.
The Latino Journal E-News wants to hear your views and encourage you to write to us. You can email your comments to: latinojournal@gmail.com.
Sunday, August 30, 2009
Without environmental protection, Latino healthcare costs will climb
Latino healthcare costs will climb without environmental protection
The Latino Journal E-News, August 24, 2009
We hear much about "Global Warming" and "Green Energy" whenever there is a discussion regarding the environment. But somehow the discussion of local environmental impacts on Latino children continue to be minimized by focusing on a global approach rather than seeking health solutions in Latino back yards. In a study conducted by the Natural Defense Resource Council (www.nrdc.org) in 2004, they found the following:
Air Pollution
In 2004, the majority of U.S. Latinos lived in areas that failed to meet the federal government's air quality standards. The regions included: The U.S.-Mexico border region, California's Central Valley, and the cities of Chicago, New York, Phoenix, and Houston. Air pollutants that stream out of power plants, vehicles, heavy machinery, and factories can lead to an increased risk of asthma, lung cancer, allergies, and chronic bronchitis and can even contribute to premature death. Air pollution takes a particular toll on pregnant women and young children, increasing the risk of complications during pregnancy and the risk of premature birth, low birth weight, and cardiac defects in babies.
Drinking Water
Thousands of U.S. residents become ill each year from drinking water contaminated with human and animal waste, pesticides, and heavy metals such as arsenic and lead. This problem is especially prevalent along the U.S.-Mexico border, where some communities lack access to sanitary sewers, and in southern and western states, where drinking water sources are polluted with arsenic and nitrates. Although some cities have excellent tap water, several with large Latino populations-such as Albuquerque, Fresno, and San Francisco-had water that was sufficiently contaminated to pose health risks to vulnerable people. Bacteria or parasites in drinking water pose health risks of waterborne diseases, which promote health effects such as diarrhea, abdominal pain, nausea, and vomiting-and some waterborne diseases such as cholera and those caused by E. coli, for example, can be fatal to humans. Arsenic, which occurs naturally in some rocks that dissolve into water supplies, is known to cause cancer of the bladder, lung, and skin and is suspected to cause cancers of the liver and kidney. Perchlorate, a component of rocket fuels and explosives, seeps into the drinking water supply, where it then exposes people to risks of diminished levels of thyroid hormone-a hormone essential for normal brain development in infants and fetuses. And nitrates found in fertilizers and human and animal feces wash into drinking water sources, where they can interfere with the blood's ability to carry oxygen to the brain and vital organs. Water quality problems that endanger Latino communities include the following: Colonias along the U.S.-Mexico border, Arizona's Maricopa County and much of Southern California.
Pesticide Exposure
Over 80 percent of U.S. farmworkers in 2004 were Latino and many wee routinely exposed to toxic pesticides through direct application or from air-drifts. In addition, pesticides settle in their drinking water, and cling to their clothes and food. The effects of exposure to some pesticides include skin rashes, burning eyes, cough, nausea, vomiting, diarrhea, and difficulty breathing. Pesticide exposure may also increase the risk of certain cancers as well as miscarriages and birth defects. Children are particularly susceptible to these harmful chemicals. Its impacts include farmworkers in California were found to have a 59 to 69 percent greater risk of stomach, cervical, and uterine cancer, and of some leukemias, compared with other Hispanics in the state.
Lead Poisoning
Even though blood lead levels have decreased steadily among the U.S. population as a whole since lead was banned in gasoline and paint in the 1970s, Hispanic children in 2004 were twice as likely as non-Hispanic white children to have blood lead levels above the threshold established by the CDC for risk of lead poisoning. In Arizona in 2002, 77 percent of children diagnosed with lead poisoning were Latinos and in San Bernardino County, California, 65 percent of lead-poisoned children were Hispanic. In children, lead is known to cause neurological problems even at tiny doses. Most notably, lead has been associated with a decline in IQ and with learning disabilities, hyperactive behavior, violence, and an increase in antisocial behavior. In adults, lead has been linked to neurological problems, high blood pressure, and kidney problems. The principal source of lead exposure for children is lead-contaminated dust (from lead-based paint), and other sources like lead-glazed pottery and some imported candy. Tradition remedies have also been identified as using lead, such as greta and azarco, often used for stomachaches.
Mercury Exposure
Although mercury exposure can cause health problems for men and women of any age, women of reproductive age and children face the greatest risk. Mercury in a pregnant woman's body can affect the developing brain of the fetus while children can develop neurological and behavioral problems, and learning disabilities. The 2004 study found that on average, Latino children had higher mercury levels in their bodies compared with non-Hispanic children. Mercury is released into the air by power plants and chemical companies, falls into water, and accumulates in fish, including the canned tuna commonly bought in stores. In 2002, for the first time, Hispanics made up the largest group of WIC participants; and according to a study in New York City, canned tuna was the most popular fish among Latinos. Mercury-contaminated fish-which cannot be distinguished by taste, touch, sight, or smell-is not only purchased but also caught by recreational and subsistence anglers.
Advisories regarding exposure to these pollutants are essential and should be provided in various languages utilizing various mediums to reach the different groups. For more information about pollution, visit www.epa.gov.
The Latino Journal E-News, August 24, 2009
We hear much about "Global Warming" and "Green Energy" whenever there is a discussion regarding the environment. But somehow the discussion of local environmental impacts on Latino children continue to be minimized by focusing on a global approach rather than seeking health solutions in Latino back yards. In a study conducted by the Natural Defense Resource Council (www.nrdc.org) in 2004, they found the following:
Air Pollution
In 2004, the majority of U.S. Latinos lived in areas that failed to meet the federal government's air quality standards. The regions included: The U.S.-Mexico border region, California's Central Valley, and the cities of Chicago, New York, Phoenix, and Houston. Air pollutants that stream out of power plants, vehicles, heavy machinery, and factories can lead to an increased risk of asthma, lung cancer, allergies, and chronic bronchitis and can even contribute to premature death. Air pollution takes a particular toll on pregnant women and young children, increasing the risk of complications during pregnancy and the risk of premature birth, low birth weight, and cardiac defects in babies.
Drinking Water
Thousands of U.S. residents become ill each year from drinking water contaminated with human and animal waste, pesticides, and heavy metals such as arsenic and lead. This problem is especially prevalent along the U.S.-Mexico border, where some communities lack access to sanitary sewers, and in southern and western states, where drinking water sources are polluted with arsenic and nitrates. Although some cities have excellent tap water, several with large Latino populations-such as Albuquerque, Fresno, and San Francisco-had water that was sufficiently contaminated to pose health risks to vulnerable people. Bacteria or parasites in drinking water pose health risks of waterborne diseases, which promote health effects such as diarrhea, abdominal pain, nausea, and vomiting-and some waterborne diseases such as cholera and those caused by E. coli, for example, can be fatal to humans. Arsenic, which occurs naturally in some rocks that dissolve into water supplies, is known to cause cancer of the bladder, lung, and skin and is suspected to cause cancers of the liver and kidney. Perchlorate, a component of rocket fuels and explosives, seeps into the drinking water supply, where it then exposes people to risks of diminished levels of thyroid hormone-a hormone essential for normal brain development in infants and fetuses. And nitrates found in fertilizers and human and animal feces wash into drinking water sources, where they can interfere with the blood's ability to carry oxygen to the brain and vital organs. Water quality problems that endanger Latino communities include the following: Colonias along the U.S.-Mexico border, Arizona's Maricopa County and much of Southern California.
Pesticide Exposure
Over 80 percent of U.S. farmworkers in 2004 were Latino and many wee routinely exposed to toxic pesticides through direct application or from air-drifts. In addition, pesticides settle in their drinking water, and cling to their clothes and food. The effects of exposure to some pesticides include skin rashes, burning eyes, cough, nausea, vomiting, diarrhea, and difficulty breathing. Pesticide exposure may also increase the risk of certain cancers as well as miscarriages and birth defects. Children are particularly susceptible to these harmful chemicals. Its impacts include farmworkers in California were found to have a 59 to 69 percent greater risk of stomach, cervical, and uterine cancer, and of some leukemias, compared with other Hispanics in the state.
Lead Poisoning
Even though blood lead levels have decreased steadily among the U.S. population as a whole since lead was banned in gasoline and paint in the 1970s, Hispanic children in 2004 were twice as likely as non-Hispanic white children to have blood lead levels above the threshold established by the CDC for risk of lead poisoning. In Arizona in 2002, 77 percent of children diagnosed with lead poisoning were Latinos and in San Bernardino County, California, 65 percent of lead-poisoned children were Hispanic. In children, lead is known to cause neurological problems even at tiny doses. Most notably, lead has been associated with a decline in IQ and with learning disabilities, hyperactive behavior, violence, and an increase in antisocial behavior. In adults, lead has been linked to neurological problems, high blood pressure, and kidney problems. The principal source of lead exposure for children is lead-contaminated dust (from lead-based paint), and other sources like lead-glazed pottery and some imported candy. Tradition remedies have also been identified as using lead, such as greta and azarco, often used for stomachaches.
Mercury Exposure
Although mercury exposure can cause health problems for men and women of any age, women of reproductive age and children face the greatest risk. Mercury in a pregnant woman's body can affect the developing brain of the fetus while children can develop neurological and behavioral problems, and learning disabilities. The 2004 study found that on average, Latino children had higher mercury levels in their bodies compared with non-Hispanic children. Mercury is released into the air by power plants and chemical companies, falls into water, and accumulates in fish, including the canned tuna commonly bought in stores. In 2002, for the first time, Hispanics made up the largest group of WIC participants; and according to a study in New York City, canned tuna was the most popular fish among Latinos. Mercury-contaminated fish-which cannot be distinguished by taste, touch, sight, or smell-is not only purchased but also caught by recreational and subsistence anglers.
Advisories regarding exposure to these pollutants are essential and should be provided in various languages utilizing various mediums to reach the different groups. For more information about pollution, visit www.epa.gov.
Saturday, August 29, 2009
Hispanics a tough sell on healthcare reform
Hispanics A Tough Sell On Health Care Reform
As A Group, They're Among The Most Likely Not To Have Coverage, But They're Wary Of Current Reform Efforts
By Niraj Chokshi, National Journal, August 24, 2009
As one of the least likely demographic groups to have insurance, Hispanics might be expected to have high hopes for the current reform efforts. Yet, more than any major demographic except Republicans, they expect an overhaul to worsen their situation.
In the nearly two dozen congressional districts with a Hispanic majority, the number of people with health insurance is 16 percentage points below the national average, according to a NationalJournal.com analysis. Hispanics accounted for 15 percent of the nation's population in 2007, but 32 percent of the nation's uninsured.
And in a Gallup survey of tens of thousands of adults this June, 42 percent of Hispanics said they were uninsured, a higher percentage than any other demographic by race, age, gender, region or economic status. The next most likely group to lack coverage -- adults making less than $36,000 -- had an uninsured rate of 29 percent.
"One of the most underserved constituencies in America is the Latino community," said Rep. Raúl Grijalva, D-Ariz., the co-chairman of the Congressional Progressive Caucus and a member of the Congressional Hispanic Caucus.
At the same time, Hispanics are more pessimistic about the current legislation than most, according to the results of a Marist poll of nearly 1,000 people released Aug. 14. When asked what impact passage of health care reform would have on themselves and their families, 41 percent of Hispanics said their situations would get worse. That percentage is the highest among all demographic groups -- by region, income, education, age, gender or households with children -- except Republicans, 54 percent of whom responded in kind.
"[There's] kind of this resignation that nothing will change," Grijalva acknowledged. His answer, and that of the congressional progressive and Hispanic groups, is a public option. Without it, "you've tied our hands; we don't have anything to sell to our community."
Leslie Sanchez, a political analyst and former Bush adviser, says there's a split between Hispanics whose families have been in the country for generations and are more concerned with cultural issues, and those who immigrated more recently and are more concerned with economic challenges. Sanchez expected the Obama administration’s and congressional Democrats’ reform efforts to play better with the latter group, while the former would be more open to Republican arguments.
"As much as we like to talk about the ‘Latino vote,’ it doesn't really exist because it's not monolithic," she said.
John Andrade, the Hispanic founder of Houston-based advertising firm Andrade Design, embodies the conflicting need for and doubt over health care reform. When he was picking out a family health insurance policy, it cost too much to cover his whole family, so he insured his wife and children but not himself. Now, he's looking to secure insurance for his five employees, something he hasn't been able to do because of high costs.
But while Andrade says reform is needed, he has little faith in a government-run health care option. "I don't think the government can take on that kind of responsibility, especially in the economic situation we're in," he said.
Nevertheless, advocates of health care reform are reaching out. On Aug. 16, the White House introduced "La Realidad," the Spanish-language version of its “Reality Check” Web site, the goal of which is to provide facts about the legislation. Meanwhile, the National Council of La Raza is embarking on a major campaign to mobilize voters behind reform.
"We're asking people to say why we need health care reform to reach our communities and families," said Jennifer Ng'andu, deputy director of the health policy project at NCLR. The group has set up dozens of meetings with congressmen and is encouraging Hispanics to attend local town halls. It’s also distributing 15,000 postcards during the August recess so Hispanics can share their stories with elected officials, targeting key states such as Montana, Connecticut, California and North Carolina.
The Republican National Hispanic Assembly, which identifies itself as "the only Hispanic Republican organization recognized as an ally of the Republican National Committee," did not respond to calls for this report.
Complicating matters for groups favoring reform is the fact that immigration -- an issue of special concern to Hispanics -- has become entwined in the debate. Opponents of the current reform effort say the legislation would fund health care for illegal immigrants, an allegation President Obama dismissed during his appearance on right-leaning radio host Michael Smerconish's talk show last week.
For their part, NCLR and Grijalva have stressed the plight of legal immigrants in their pro-reform rhetoric. One specific goal both are pushing for is a lift of a five-year waiting period for immigrants on receiving certain government benefits such as Medicare and Medicaid. "You're punishing somebody for going through the process of becoming legal," Grijalva said.
A plurality of uninsured Hispanics surveyed by the Pew Hispanic Center in 2007, 37 percent, said they lacked health insurance because it was too expensive. Eighteen percent cited "some other reason," and the remainder cited reasons such as not qualifying for employer-based coverage (9 percent), not knowing how to get insurance (8 percent) and being restricted by their immigration status (8 percent). Ng'andu pointed to a low rate of employer-sponsored health care across economic class among Hispanics. According to 2007 census data, 20 percent of Hispanics making over $75,000 a year were uninsured. The rate for whites making less than $25,000 a year was 19 percent.
Andrade said part of the problem may also be cultural. His father-in-law, he says, is often reluctant to seek medical care. "If you go to the doctor, either you're weak or you could get sick or it's just bad luck to even think about," Andrade said.
His friend Lionel Sosa, a Hispanic media consultant on seven Republican presidential campaigns, agreed.
"Men are very macho,” he said. “They'll wait until they're dead before they go to the doctor."
As A Group, They're Among The Most Likely Not To Have Coverage, But They're Wary Of Current Reform Efforts
By Niraj Chokshi, National Journal, August 24, 2009
As one of the least likely demographic groups to have insurance, Hispanics might be expected to have high hopes for the current reform efforts. Yet, more than any major demographic except Republicans, they expect an overhaul to worsen their situation.
In the nearly two dozen congressional districts with a Hispanic majority, the number of people with health insurance is 16 percentage points below the national average, according to a NationalJournal.com analysis. Hispanics accounted for 15 percent of the nation's population in 2007, but 32 percent of the nation's uninsured.
And in a Gallup survey of tens of thousands of adults this June, 42 percent of Hispanics said they were uninsured, a higher percentage than any other demographic by race, age, gender, region or economic status. The next most likely group to lack coverage -- adults making less than $36,000 -- had an uninsured rate of 29 percent.
"One of the most underserved constituencies in America is the Latino community," said Rep. Raúl Grijalva, D-Ariz., the co-chairman of the Congressional Progressive Caucus and a member of the Congressional Hispanic Caucus.
At the same time, Hispanics are more pessimistic about the current legislation than most, according to the results of a Marist poll of nearly 1,000 people released Aug. 14. When asked what impact passage of health care reform would have on themselves and their families, 41 percent of Hispanics said their situations would get worse. That percentage is the highest among all demographic groups -- by region, income, education, age, gender or households with children -- except Republicans, 54 percent of whom responded in kind.
"[There's] kind of this resignation that nothing will change," Grijalva acknowledged. His answer, and that of the congressional progressive and Hispanic groups, is a public option. Without it, "you've tied our hands; we don't have anything to sell to our community."
Leslie Sanchez, a political analyst and former Bush adviser, says there's a split between Hispanics whose families have been in the country for generations and are more concerned with cultural issues, and those who immigrated more recently and are more concerned with economic challenges. Sanchez expected the Obama administration’s and congressional Democrats’ reform efforts to play better with the latter group, while the former would be more open to Republican arguments.
"As much as we like to talk about the ‘Latino vote,’ it doesn't really exist because it's not monolithic," she said.
John Andrade, the Hispanic founder of Houston-based advertising firm Andrade Design, embodies the conflicting need for and doubt over health care reform. When he was picking out a family health insurance policy, it cost too much to cover his whole family, so he insured his wife and children but not himself. Now, he's looking to secure insurance for his five employees, something he hasn't been able to do because of high costs.
But while Andrade says reform is needed, he has little faith in a government-run health care option. "I don't think the government can take on that kind of responsibility, especially in the economic situation we're in," he said.
Nevertheless, advocates of health care reform are reaching out. On Aug. 16, the White House introduced "La Realidad," the Spanish-language version of its “Reality Check” Web site, the goal of which is to provide facts about the legislation. Meanwhile, the National Council of La Raza is embarking on a major campaign to mobilize voters behind reform.
"We're asking people to say why we need health care reform to reach our communities and families," said Jennifer Ng'andu, deputy director of the health policy project at NCLR. The group has set up dozens of meetings with congressmen and is encouraging Hispanics to attend local town halls. It’s also distributing 15,000 postcards during the August recess so Hispanics can share their stories with elected officials, targeting key states such as Montana, Connecticut, California and North Carolina.
The Republican National Hispanic Assembly, which identifies itself as "the only Hispanic Republican organization recognized as an ally of the Republican National Committee," did not respond to calls for this report.
Complicating matters for groups favoring reform is the fact that immigration -- an issue of special concern to Hispanics -- has become entwined in the debate. Opponents of the current reform effort say the legislation would fund health care for illegal immigrants, an allegation President Obama dismissed during his appearance on right-leaning radio host Michael Smerconish's talk show last week.
For their part, NCLR and Grijalva have stressed the plight of legal immigrants in their pro-reform rhetoric. One specific goal both are pushing for is a lift of a five-year waiting period for immigrants on receiving certain government benefits such as Medicare and Medicaid. "You're punishing somebody for going through the process of becoming legal," Grijalva said.
A plurality of uninsured Hispanics surveyed by the Pew Hispanic Center in 2007, 37 percent, said they lacked health insurance because it was too expensive. Eighteen percent cited "some other reason," and the remainder cited reasons such as not qualifying for employer-based coverage (9 percent), not knowing how to get insurance (8 percent) and being restricted by their immigration status (8 percent). Ng'andu pointed to a low rate of employer-sponsored health care across economic class among Hispanics. According to 2007 census data, 20 percent of Hispanics making over $75,000 a year were uninsured. The rate for whites making less than $25,000 a year was 19 percent.
Andrade said part of the problem may also be cultural. His father-in-law, he says, is often reluctant to seek medical care. "If you go to the doctor, either you're weak or you could get sick or it's just bad luck to even think about," Andrade said.
His friend Lionel Sosa, a Hispanic media consultant on seven Republican presidential campaigns, agreed.
"Men are very macho,” he said. “They'll wait until they're dead before they go to the doctor."
Hispanic Dental Association to host meeting
Hispanic Dental Association 17th Annual Meeting
PRESS RELEASE
SPRINGFIELD, Ill., Aug. 24 /PRNewswire-HISPANIC PR WIRE/ -- The Hispanic Dental Association, a national organization of dental professionals dedicated to promoting and improving the oral health of the Hispanic community and providing advocacy for Hispanic oral health professionals across the United States, invites you to our 17th Annual Meeting on October 22-24, 2009 at the Hilton Americas Houston Hotel in Houston, Texas. Come take advantage of this excellent opportunity to participate in continuing education as well as to network and socialize with dental professionals and students who have a passionate interest in Hispanic oral health. Our Meeting Theme this year is LAUNCHING SOLUTIONS FOR OPTIMAL HISPANIC ORAL HEALTH.
To learn more about all the wonderful meeting events and to register, please visit our website at www.hdassoc.org.
To contact the National Office of the Hispanic Dental Association, please call 800-852-7921 or email hispanicdental@hdassoc.org.
PRESS RELEASE
SPRINGFIELD, Ill., Aug. 24 /PRNewswire-HISPANIC PR WIRE/ -- The Hispanic Dental Association, a national organization of dental professionals dedicated to promoting and improving the oral health of the Hispanic community and providing advocacy for Hispanic oral health professionals across the United States, invites you to our 17th Annual Meeting on October 22-24, 2009 at the Hilton Americas Houston Hotel in Houston, Texas. Come take advantage of this excellent opportunity to participate in continuing education as well as to network and socialize with dental professionals and students who have a passionate interest in Hispanic oral health. Our Meeting Theme this year is LAUNCHING SOLUTIONS FOR OPTIMAL HISPANIC ORAL HEALTH.
To learn more about all the wonderful meeting events and to register, please visit our website at www.hdassoc.org.
To contact the National Office of the Hispanic Dental Association, please call 800-852-7921 or email hispanicdental@hdassoc.org.
Latino teen weight linked to unsafe neighborhoods
Unsafe Urban Neighborhoods Linked to Teen Weight
By Joene Hendry, ABC News, August 24, 2009
NEW YORK (Reuters Health) - Living in an urban neighborhood that feels unsafe may be a factor in a teen's risk for being overweight, hints a study of public high school students in Boston, Massachusetts.
Of the 1,140 students surveyed, nearly 12 percent said they rarely felt safe in their neighborhood and 9 percent said they never felt safe in their neighborhood.
These students were about 1.2-times more likely to be overweight or at risk for becoming overweight compared with students who said they sometimes or always felt safe (44 percent) or always felt safe (36 percent), researchers report in the online journal Public Health, published by BioMed Central.
The risk for being overweight was in excess of 1.5 times among students who listed their race as "other" - Asian, South Asian, American Indian, Alaska Natives, Native Hawaiians, and other Pacific Islanders - and said they never or rarely felt safe.
That adolescents feel unsafe in their neighborhoods "is concerning on its own," Dustin T. Duncan, a doctoral candidate at Harvard School of Public Health, noted in an email to Reuters Health. That neighborhood safety may be a factor in overweight among teens is doubly concerning, he added.
Duncan's team analyzed health behaviors, use of school and community resources, and exposure to violence reported in the 2006 Boston Youth Survey. This representative sampling of students in grades 9 through 12 included non-Hispanic Blacks (47 percent) and Hispanics (30 percent). Non-Hispanic Whites and "Other" races comprised 13 and 11 percent.
Overall, half the Hispanic students were at risk for being overweight, as were 46, 39, and 34 percent of students who were Black, White, and Other race or ethnicity. Male and female (58 percent) students had similar risk for being overweight.
The researchers report a greater proportion (68 percent) of the students who rarely or never felt safe said gang violence was a serious neighborhood problem. Nearly 18 percent of these teens had witnessed assaults in the previous year.
By contrast, of those who said they sometimes or always felt safe, 44 and 11 percent, respectively, cited gang violence as a problem and had witnessed assaults.
Duncan's group, therefore, suggests policies and programs to address gang activity and violence may also help prevent urban-living teens from becoming overweight.
SOURCE: BMC Public Health, August 2009
By Joene Hendry, ABC News, August 24, 2009
NEW YORK (Reuters Health) - Living in an urban neighborhood that feels unsafe may be a factor in a teen's risk for being overweight, hints a study of public high school students in Boston, Massachusetts.
Of the 1,140 students surveyed, nearly 12 percent said they rarely felt safe in their neighborhood and 9 percent said they never felt safe in their neighborhood.
These students were about 1.2-times more likely to be overweight or at risk for becoming overweight compared with students who said they sometimes or always felt safe (44 percent) or always felt safe (36 percent), researchers report in the online journal Public Health, published by BioMed Central.
The risk for being overweight was in excess of 1.5 times among students who listed their race as "other" - Asian, South Asian, American Indian, Alaska Natives, Native Hawaiians, and other Pacific Islanders - and said they never or rarely felt safe.
That adolescents feel unsafe in their neighborhoods "is concerning on its own," Dustin T. Duncan, a doctoral candidate at Harvard School of Public Health, noted in an email to Reuters Health. That neighborhood safety may be a factor in overweight among teens is doubly concerning, he added.
Duncan's team analyzed health behaviors, use of school and community resources, and exposure to violence reported in the 2006 Boston Youth Survey. This representative sampling of students in grades 9 through 12 included non-Hispanic Blacks (47 percent) and Hispanics (30 percent). Non-Hispanic Whites and "Other" races comprised 13 and 11 percent.
Overall, half the Hispanic students were at risk for being overweight, as were 46, 39, and 34 percent of students who were Black, White, and Other race or ethnicity. Male and female (58 percent) students had similar risk for being overweight.
The researchers report a greater proportion (68 percent) of the students who rarely or never felt safe said gang violence was a serious neighborhood problem. Nearly 18 percent of these teens had witnessed assaults in the previous year.
By contrast, of those who said they sometimes or always felt safe, 44 and 11 percent, respectively, cited gang violence as a problem and had witnessed assaults.
Duncan's group, therefore, suggests policies and programs to address gang activity and violence may also help prevent urban-living teens from becoming overweight.
SOURCE: BMC Public Health, August 2009
Study on Hispanic organ donation
Former nursing student helps conduct study on Hispanic organ donation
Andrea Bolt, TCU Daily, 8/28/09
In May, former nursing student Jennifer Zemplinski compiled a literature review about the study she helped conduct concerning the Hispanic community and the subject of organ donation, specifically, the lack of organ donation within the community.
Associate professor and Harris College Doctor of Nursing Practice Program director Dr. Kathy Baker compiled the study, "Hispanic Perspectives Regarding Organ Donation," to understand the Hispanic community's feelings and knowledge of organ donation in order to ultimately increase Hispanic American donor rates.
According to the study, more education and publicity is needed to circulate in the Hispanic community because the willingness to learn more about organ donation was prevalent. Also, many culturally-based fears and misconceptions were apparent in the participants.
Zemplinski wrote in her review that four main themes in the data were found to influence willingness to donate; awareness, knowledge level, emotions and values. Zemplinski included that several of the participants believed it was good to donate, however, donation conflicted with the beliefs their parents taught them, beliefs that the body must be buried whole or the belief that the church did not support donation. Zemplinski wrote that the study aimed to increase current knowledge about the Hispanic communities' thoughts and feelings regarding organ donation, realizing the vision of one participant who stated, "I hope Hispanics donate more."
The study's results have since been shown at the Sigma Theta Tau Nursing Honors Society Symposium and at the Arlington Memorial Hospital.
Zemplinski's extensive work and review also led to her being named a winner of the 2009 Harris College Research Symposium.
Dr. Susan Rugari, nursing assistant professor, said Zemplinski was an undergraduate during the time of the study, a fact that made an impact on all faculty involved.
Rugari, who assisted in data analysis and review, said Zemplinski did great work.
Hispanic Studies and Spanish professor David Bedford, who assisted in translation and gave input about Hispanic culture, said that Zemplinski was very important to the study.
Zemplinski is currently working at Cook Children's Hospital in Fort Worth,
"I am working in a hospital and trying to become a competent nurse that can serve my families," Zemplinski wrote in an e-mail. She wrote that she may return to graduate school and continue the project then.
Currently Dr. Baker and Dr. Rugari are working together to produce a published manuscript of the study. They plan to submit the manuscript to the Journal of Transcultural Nursing, Dr. Rugari said.
After giving it "a little polish and a little enhancement," said Dr. Rugari, they hope to have the manuscript published possibly as soon as October.
Andrea Bolt, TCU Daily, 8/28/09
In May, former nursing student Jennifer Zemplinski compiled a literature review about the study she helped conduct concerning the Hispanic community and the subject of organ donation, specifically, the lack of organ donation within the community.
Associate professor and Harris College Doctor of Nursing Practice Program director Dr. Kathy Baker compiled the study, "Hispanic Perspectives Regarding Organ Donation," to understand the Hispanic community's feelings and knowledge of organ donation in order to ultimately increase Hispanic American donor rates.
According to the study, more education and publicity is needed to circulate in the Hispanic community because the willingness to learn more about organ donation was prevalent. Also, many culturally-based fears and misconceptions were apparent in the participants.
Zemplinski wrote in her review that four main themes in the data were found to influence willingness to donate; awareness, knowledge level, emotions and values. Zemplinski included that several of the participants believed it was good to donate, however, donation conflicted with the beliefs their parents taught them, beliefs that the body must be buried whole or the belief that the church did not support donation. Zemplinski wrote that the study aimed to increase current knowledge about the Hispanic communities' thoughts and feelings regarding organ donation, realizing the vision of one participant who stated, "I hope Hispanics donate more."
The study's results have since been shown at the Sigma Theta Tau Nursing Honors Society Symposium and at the Arlington Memorial Hospital.
Zemplinski's extensive work and review also led to her being named a winner of the 2009 Harris College Research Symposium.
Dr. Susan Rugari, nursing assistant professor, said Zemplinski was an undergraduate during the time of the study, a fact that made an impact on all faculty involved.
Rugari, who assisted in data analysis and review, said Zemplinski did great work.
Hispanic Studies and Spanish professor David Bedford, who assisted in translation and gave input about Hispanic culture, said that Zemplinski was very important to the study.
Zemplinski is currently working at Cook Children's Hospital in Fort Worth,
"I am working in a hospital and trying to become a competent nurse that can serve my families," Zemplinski wrote in an e-mail. She wrote that she may return to graduate school and continue the project then.
Currently Dr. Baker and Dr. Rugari are working together to produce a published manuscript of the study. They plan to submit the manuscript to the Journal of Transcultural Nursing, Dr. Rugari said.
After giving it "a little polish and a little enhancement," said Dr. Rugari, they hope to have the manuscript published possibly as soon as October.
Latinos at higher risk for swine flu
Swine flu: Are blacks and Latinos at higher risk?
LA Times, August 27, 2009
In the early stages of the pandemic H1N1 influenza outbreak in Chicago, blacks and Latinos were about four times more likely than Caucasians to contract the virus, according to the first study that has examined the racial composition of those who caught the flu. Children were also 14 times as likely as the elderly to contract the virus, according to a report from the Chicago Department of Public Health in today's edition of the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
Despite the figures, CDC officials said it is unlikely that there is any genetic factor underlying the increased susceptibility. Rather, both blacks and Latinos suffer from higher rates of asthma, diabetes and other medical conditions that make them more susceptible to the new virus, commonly known as swine flu.
Illinois and Wisconsin had an unusually high incidence of laboratory-confirmed cases of the flu, surprising because of their distance from Mexico, the initial focus of the outbreak. But both states had aggressive laboratory testing programs and most likely simply detected a higher number of cases that would otherwise have gone unnoticed.
Today's report showed 1,557 laboratory-confirmed cases of pandemic H1N1 virus in Chicago in the 14 weeks ending July 25. Children ages 5 to 14 had the highest infection rate, 147 cases per 100,000 population -- 14 times higher than that for adults over the age of 60. Previous studies have shown that the elderly, who are normally the primary victims of seasonal flu, may have some resistance to the new virus because of previous exposures to swine-related flu viruses. A total of 205 patients were hospitalized, about 13% of those infected. Children up to 4 years old had the highest hospitalization rate, 25 per 100,000, followed by those aged 5 to 14 at 11 per 100,000.
Blacks were hospitalized at a rate of nine per 100,000 and Latinos at eight per 100,000, compared to the rate of two per 100,000 in Caucasians. Earlier this month, Boston public health authorities released some preliminary information suggesting that blacks and Latinos accounted for three-quarters of hospitalizations in that city. But Dr. Dan Jernigan of the CDC noted that the early stages of the epidemic struck neighborhoods rather randomly, and the outcomes might be due simply to chance -- as well as the higher rate of underlying disease in those populations.
Among the 205 hospitalized patients, 40 were admitted to the intensive care unit and nine required mechanical ventilation. Fourteen of the hospitalized patients were pregnant, one of whom died after giving birth by caesarean section. Among the 177 hospitalized patients for whom information was available, 37 (21%) had a previous diagnosis of asthma and 13 (7%) had a diagnosis of diabetes.
-- Thomas H. Maugh II
LA Times, August 27, 2009
In the early stages of the pandemic H1N1 influenza outbreak in Chicago, blacks and Latinos were about four times more likely than Caucasians to contract the virus, according to the first study that has examined the racial composition of those who caught the flu. Children were also 14 times as likely as the elderly to contract the virus, according to a report from the Chicago Department of Public Health in today's edition of the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
Despite the figures, CDC officials said it is unlikely that there is any genetic factor underlying the increased susceptibility. Rather, both blacks and Latinos suffer from higher rates of asthma, diabetes and other medical conditions that make them more susceptible to the new virus, commonly known as swine flu.
Illinois and Wisconsin had an unusually high incidence of laboratory-confirmed cases of the flu, surprising because of their distance from Mexico, the initial focus of the outbreak. But both states had aggressive laboratory testing programs and most likely simply detected a higher number of cases that would otherwise have gone unnoticed.
Today's report showed 1,557 laboratory-confirmed cases of pandemic H1N1 virus in Chicago in the 14 weeks ending July 25. Children ages 5 to 14 had the highest infection rate, 147 cases per 100,000 population -- 14 times higher than that for adults over the age of 60. Previous studies have shown that the elderly, who are normally the primary victims of seasonal flu, may have some resistance to the new virus because of previous exposures to swine-related flu viruses. A total of 205 patients were hospitalized, about 13% of those infected. Children up to 4 years old had the highest hospitalization rate, 25 per 100,000, followed by those aged 5 to 14 at 11 per 100,000.
Blacks were hospitalized at a rate of nine per 100,000 and Latinos at eight per 100,000, compared to the rate of two per 100,000 in Caucasians. Earlier this month, Boston public health authorities released some preliminary information suggesting that blacks and Latinos accounted for three-quarters of hospitalizations in that city. But Dr. Dan Jernigan of the CDC noted that the early stages of the epidemic struck neighborhoods rather randomly, and the outcomes might be due simply to chance -- as well as the higher rate of underlying disease in those populations.
Among the 205 hospitalized patients, 40 were admitted to the intensive care unit and nine required mechanical ventilation. Fourteen of the hospitalized patients were pregnant, one of whom died after giving birth by caesarean section. Among the 177 hospitalized patients for whom information was available, 37 (21%) had a previous diagnosis of asthma and 13 (7%) had a diagnosis of diabetes.
-- Thomas H. Maugh II
Sunday, August 23, 2009
Latino health in jeopardy without healthcare now
Opinion: Waiting for healthcare reform puts Latino health in jeopardy
By Adrian Perez, The Latino Journal E-News, August 17, 2009
There is no question that the nation is in need of healthcare reform and it really doesn't matter who or which party writes it as long as it can cast a net large enough to protect the millions now without any healthcare. Latinos would greatly benefit from such legislation, provided it is fair and written with people's health in mind.
As the public debate focuses on moral components and total cost, there appears to be total indifference as to when it would be implemented and what mechanisms are in place to balance those portions of the law that fail, like the growing true costs of triage treatment and medications.
The proposed Healthcare Reform Act is being hastily rushed through Congress, on its way to certain signature by President Obama. However, it would not go into effect until 2013. Why? The need for such reform is now. Yet, Congress doesn't feel it would be essential to implement it until 4 years from now. With Latinos facing a major health crisis called "obesity," a problem that increases the risk of diabetes, heart disease, cancer, and other illnesses that cause early death, healthcare has become ever more urgent.
Is obesity among Latinos preventable? Of course, but only through proper and early medical care intervention. But, since this act doesn't go into effect until 2013, many Latinos will continue to use emergency rooms for healthcare, receiving more intrusive and expensive medical care.
Congress should pass the Healthcare Reform Act, but it should include immediate implementation. Waiting for its implementation gives the appearance healthcare reform is not that urgent. In the meantime, the patient is flat lining.
By Adrian Perez, The Latino Journal E-News, August 17, 2009
There is no question that the nation is in need of healthcare reform and it really doesn't matter who or which party writes it as long as it can cast a net large enough to protect the millions now without any healthcare. Latinos would greatly benefit from such legislation, provided it is fair and written with people's health in mind.
As the public debate focuses on moral components and total cost, there appears to be total indifference as to when it would be implemented and what mechanisms are in place to balance those portions of the law that fail, like the growing true costs of triage treatment and medications.
The proposed Healthcare Reform Act is being hastily rushed through Congress, on its way to certain signature by President Obama. However, it would not go into effect until 2013. Why? The need for such reform is now. Yet, Congress doesn't feel it would be essential to implement it until 4 years from now. With Latinos facing a major health crisis called "obesity," a problem that increases the risk of diabetes, heart disease, cancer, and other illnesses that cause early death, healthcare has become ever more urgent.
Is obesity among Latinos preventable? Of course, but only through proper and early medical care intervention. But, since this act doesn't go into effect until 2013, many Latinos will continue to use emergency rooms for healthcare, receiving more intrusive and expensive medical care.
Congress should pass the Healthcare Reform Act, but it should include immediate implementation. Waiting for its implementation gives the appearance healthcare reform is not that urgent. In the meantime, the patient is flat lining.
Latinos and the healthcare reform act
Behind The Healthcare Reform Act
Part 2 of 3
The Latino Journal E-News, August 17, 2009
The America's Affordable Health Choices Act is a 1017 page proposed legislation that is requiring Legislators to attend workshops so they can learn what it does. The Act would not provide immediate resolutions to healthcare becuase it will not be implemented until 2013. As mentioned last week, we are looking at the pros and cons of this legislation. The following are the cons, from a Latino perspective:
Provisions of the Healthcare Act:
1. Coverage and Choice
The Act says it will protect current coverage and allow individuals to keep the insurance they have if they like it - and preserves choice of doctors, hospitals, and health plans. Unfortunately this won't be possible. As employers find it either more difficult to compete for healthcare insurance or are unable to afford it, Americans will be shifted to a government-runned healthcare program where a medical board will decide overall patient coverage and outcomes based on age and value to society, like in England. In addition, the Latino population takes care of its elderly through Medicare. Through this portion of the Act, Medicare for seniors would be cut forcing them to look for services outside the system.
2. Affordability
It will cap annual out-of-pocket spending, create competition among healthcare insurance providers, expands Medicaid, and improves Medicare. It will actually put insurance companies out of business, creating only one competitor, the government. It will expand Medicaid, but cut back on Medicare Advantage for seniors. The Office of Management and Budget has predicted that the cost of this Act will reach over $1 trillion, a cost that will be forwarded to future generations. Additionally, it will prohibit the purchase of medications or seek medical care outside the U.S., again eliminating competition. Finally, the lack of healthcare providers will also drive the costs up.
3. Shared Responsibility
The bill creates shared responsibility among individuals, employers and government to ensure that all Americans have affordable coverage of essential health benefits. This is based on the economy recovering and predicting business growth by its implementatio year of 2013. In actuality, it will be small business owners that will pay for this program as they are forced to purchase healthcare for their employees or face fines. Small business owners will not have an option, creating tough decision if they should hire another person, or let go of one to pay for coverage, the fines, or both. Small businesses are the country's largest employers.
4. Prevention and Wellness
This includes a focus on community based program and new data collection to better identify and address racial, ethnic, regional and other health disparities and funds to strengthen state, local, tribal and territorial public health departments and programs. This means organizations like NCLR, ACORN, AARP, etc., and others with strong political presence will receive funding to get folks educated on wellness, instead of using that funding (hundreds of millions) to improve healthcare access, like helping struggling small businesses pay for their employee's healthcare.
5. Workforce Investments
It will expand health care workforce and expand scholarships and loans for individuals in needed professions and shortage areas. Of all the medical school graduates, only 6,500 seek to work in general healthcare areas because of the long work hours and low salaries, creating an expanding void each year. There is no provision to address the void, like using foreign physicians. In addition, the Act discusses providing college scholarships, but the problem is getting Latinos students to finish high school.
6. Controlling Costs
The bill will reduce the growth in health care spending as it is implemented. This is a misrepresentation of the basics of supply and demand. In actuality, the costs will continue to grow as competition is minimized and demand increases, including employers shifting from independent healthcare to government-runned healthcare.
The Latino Journal E-News will be providing pro comments from a Latino perspective regarding the components within the provisions of the Act next week. If you want to chime in, please write to us and let us know your position on this hot topic. You can email your comments to: latinojournal@gmail.com.
Part 2 of 3
The Latino Journal E-News, August 17, 2009
The America's Affordable Health Choices Act is a 1017 page proposed legislation that is requiring Legislators to attend workshops so they can learn what it does. The Act would not provide immediate resolutions to healthcare becuase it will not be implemented until 2013. As mentioned last week, we are looking at the pros and cons of this legislation. The following are the cons, from a Latino perspective:
Provisions of the Healthcare Act:
1. Coverage and Choice
The Act says it will protect current coverage and allow individuals to keep the insurance they have if they like it - and preserves choice of doctors, hospitals, and health plans. Unfortunately this won't be possible. As employers find it either more difficult to compete for healthcare insurance or are unable to afford it, Americans will be shifted to a government-runned healthcare program where a medical board will decide overall patient coverage and outcomes based on age and value to society, like in England. In addition, the Latino population takes care of its elderly through Medicare. Through this portion of the Act, Medicare for seniors would be cut forcing them to look for services outside the system.
2. Affordability
It will cap annual out-of-pocket spending, create competition among healthcare insurance providers, expands Medicaid, and improves Medicare. It will actually put insurance companies out of business, creating only one competitor, the government. It will expand Medicaid, but cut back on Medicare Advantage for seniors. The Office of Management and Budget has predicted that the cost of this Act will reach over $1 trillion, a cost that will be forwarded to future generations. Additionally, it will prohibit the purchase of medications or seek medical care outside the U.S., again eliminating competition. Finally, the lack of healthcare providers will also drive the costs up.
3. Shared Responsibility
The bill creates shared responsibility among individuals, employers and government to ensure that all Americans have affordable coverage of essential health benefits. This is based on the economy recovering and predicting business growth by its implementatio year of 2013. In actuality, it will be small business owners that will pay for this program as they are forced to purchase healthcare for their employees or face fines. Small business owners will not have an option, creating tough decision if they should hire another person, or let go of one to pay for coverage, the fines, or both. Small businesses are the country's largest employers.
4. Prevention and Wellness
This includes a focus on community based program and new data collection to better identify and address racial, ethnic, regional and other health disparities and funds to strengthen state, local, tribal and territorial public health departments and programs. This means organizations like NCLR, ACORN, AARP, etc., and others with strong political presence will receive funding to get folks educated on wellness, instead of using that funding (hundreds of millions) to improve healthcare access, like helping struggling small businesses pay for their employee's healthcare.
5. Workforce Investments
It will expand health care workforce and expand scholarships and loans for individuals in needed professions and shortage areas. Of all the medical school graduates, only 6,500 seek to work in general healthcare areas because of the long work hours and low salaries, creating an expanding void each year. There is no provision to address the void, like using foreign physicians. In addition, the Act discusses providing college scholarships, but the problem is getting Latinos students to finish high school.
6. Controlling Costs
The bill will reduce the growth in health care spending as it is implemented. This is a misrepresentation of the basics of supply and demand. In actuality, the costs will continue to grow as competition is minimized and demand increases, including employers shifting from independent healthcare to government-runned healthcare.
The Latino Journal E-News will be providing pro comments from a Latino perspective regarding the components within the provisions of the Act next week. If you want to chime in, please write to us and let us know your position on this hot topic. You can email your comments to: latinojournal@gmail.com.
Latino children hurt by California budget cuts
Latino children hurt by California's budget cuts
The Latino Journal E-News, August 17, 2009
In an effort to stave off a $24.3 billion dollar deficit, California Governor Arnold Schwarzenegger (R) has negotiated with democratic legislative leaders to cut funding for a program called Healthy Families. It is California's version of the national Children's Health Insurance Program, which covers more than 900,000 California children. The $200 million cut will result in the state also losing federal matching funds, an amount estimated to be around $700 million per year. More importantly, tens of thousands of Latino children will be cut or not admitted for healthcare.
In his statement regarding the budget cut, Governor Schwarzenegger said "All of those are very, very tough decisions. That's why I call them ugly, not bad, but ugly. Those are very ugly cuts."
Healthy Families is a program designed to provide healthcare to children from households with incomes that do not exceed 250% of the federal poverty level. Through Healthy Families, healthcare is provided to children through mostly rural clinics that also serve large Latino populations. But, with their budgets cut, many of these clinics may need to close and the number of children that can be helped being capped. There are over 60,000 children on the waiting list with no hope of being covered.
"Our Healthy Families Program will be short $552.4 million (including federal matching funds)," said Janette Lopez from the California Managed Risk Medical Insurance Board, which administers the Healthy Families program.
The cuts have pushed the state board to find other money, cut other costs, or reduce more than half a million children from the statewide program. Some program cuts may include services like vision, biofeedback, acupuncture and chiropractic. In addition, the board is considering raising co-pays, some of which are currently zero.
Rural California is not only home to many farm workers, but also covers regions with years of agricultural activity resulting in of water and air-borne pollutants. The environmental issues are so prominent in these regions that scientists and groups like the American Lung Association have been pushing to evaluate the health risks encountered by children exposed to agricultural chemicals. But, without the Healthy Families programs, it will be difficult to study the environmental human impacts on children.
For more information about Healthy Families, visit their website at www.healthyfamilies.ca.gov.
The Latino Journal E-News, August 17, 2009
In an effort to stave off a $24.3 billion dollar deficit, California Governor Arnold Schwarzenegger (R) has negotiated with democratic legislative leaders to cut funding for a program called Healthy Families. It is California's version of the national Children's Health Insurance Program, which covers more than 900,000 California children. The $200 million cut will result in the state also losing federal matching funds, an amount estimated to be around $700 million per year. More importantly, tens of thousands of Latino children will be cut or not admitted for healthcare.
In his statement regarding the budget cut, Governor Schwarzenegger said "All of those are very, very tough decisions. That's why I call them ugly, not bad, but ugly. Those are very ugly cuts."
Healthy Families is a program designed to provide healthcare to children from households with incomes that do not exceed 250% of the federal poverty level. Through Healthy Families, healthcare is provided to children through mostly rural clinics that also serve large Latino populations. But, with their budgets cut, many of these clinics may need to close and the number of children that can be helped being capped. There are over 60,000 children on the waiting list with no hope of being covered.
"Our Healthy Families Program will be short $552.4 million (including federal matching funds)," said Janette Lopez from the California Managed Risk Medical Insurance Board, which administers the Healthy Families program.
The cuts have pushed the state board to find other money, cut other costs, or reduce more than half a million children from the statewide program. Some program cuts may include services like vision, biofeedback, acupuncture and chiropractic. In addition, the board is considering raising co-pays, some of which are currently zero.
Rural California is not only home to many farm workers, but also covers regions with years of agricultural activity resulting in of water and air-borne pollutants. The environmental issues are so prominent in these regions that scientists and groups like the American Lung Association have been pushing to evaluate the health risks encountered by children exposed to agricultural chemicals. But, without the Healthy Families programs, it will be difficult to study the environmental human impacts on children.
For more information about Healthy Families, visit their website at www.healthyfamilies.ca.gov.
Latinos and diabetes
Diabetes in the Latino community
The Latino Journal E-News, August 17, 2009
Latinos suffer from a very high incidence of diabetes. But, what is diabetes and why should we be concerned?
Diabetes is one of the leading causes of death and disability for Latinos in the United States. There are actually two types of Diabetes: Type 1, which results when the body's immune system attacks and destroys its own insulin-producing beta cells in the pancreas; and, Type 2, which occurs when the body does not make enough insulin or cannot us the insulin it makes effectively. Of the two, Type 2 is the most common, comprising 90 to 95 percent of all diagnosed cases of diabetes.
People are at risk to develop Type 2 diabetes if they:
* Have a family history of diabetes;
* Are Latino;
* Are overweight or obese;
* Are 45 years of age or older;
* Have had diabetes while pregnant (also known as gestational diabetes);
* Have high blood pressure;
* Have abnormal cholesterol levels;
* Are not getting enough physical activity;
* Have polycystic ovary syndrome;
* Have blood vessel problems affecting the heart, brain, or legs; or,
* Have dark, thick and velvety patches of skin around the neck and armpits.
So how many Latinos in the U.S. suffer from diabetes? The National Diabetes Education Program estimates that 10.4 percent of all Latinos, ages 20 and older, have been diagnosed with diabetes. Of the 10.4 percent, those of Mexican descent comprise the largest number with diagnosed diabetes, followed by Puerto Ricans, Cubans and other Latin American national roots.
Diabetes is a concern in the Latino community because it has been found that about 68 percent of those afflicted die from heart disease or stroke at an early age - that is two to four times higher than adults without diabetes. Smokers are especially vulnerable.
Preventing diabetes and minimizing its related complications is based on a self-managed effort, meaning any person afflicted with the disease must take personal responsibility for their day-to-day care. Adults at age 20 and older should at a minimum:
* Check glucose levels at least twice a year, ensuring that readings do not exceed 120 while fasting and 180 after meals;
* Check blood pressure levels at every doctor visit, ensuring pressure levels are maintained below 130/80; and,
* Check cholesterol levels at least once a year, ensuring levels of LDL do not exceed 200.
In addition, adults age 20 and older should ensure that:
* They lose 5 to 7 percent of their body weight (that equates to 10 to 40 pounds for a person who weighs 200 pounds and is clearly overweight;
* Be physically active for at least 30 minutes per day, 5 days a week (brisk walking for example); and,
* Enjoy healthier and natural foods, high in caloric values and protein, and low in refined sugars and enriched flour (the brighter the color, the healthier it is).
For more information about preventing and controlling diabetes, call 1-888-693- 6337 or visit the National Diabetes Education Program website at www.yourdiabetesinfo.org.
The Latino Journal E-News, August 17, 2009
Latinos suffer from a very high incidence of diabetes. But, what is diabetes and why should we be concerned?
Diabetes is one of the leading causes of death and disability for Latinos in the United States. There are actually two types of Diabetes: Type 1, which results when the body's immune system attacks and destroys its own insulin-producing beta cells in the pancreas; and, Type 2, which occurs when the body does not make enough insulin or cannot us the insulin it makes effectively. Of the two, Type 2 is the most common, comprising 90 to 95 percent of all diagnosed cases of diabetes.
People are at risk to develop Type 2 diabetes if they:
* Have a family history of diabetes;
* Are Latino;
* Are overweight or obese;
* Are 45 years of age or older;
* Have had diabetes while pregnant (also known as gestational diabetes);
* Have high blood pressure;
* Have abnormal cholesterol levels;
* Are not getting enough physical activity;
* Have polycystic ovary syndrome;
* Have blood vessel problems affecting the heart, brain, or legs; or,
* Have dark, thick and velvety patches of skin around the neck and armpits.
So how many Latinos in the U.S. suffer from diabetes? The National Diabetes Education Program estimates that 10.4 percent of all Latinos, ages 20 and older, have been diagnosed with diabetes. Of the 10.4 percent, those of Mexican descent comprise the largest number with diagnosed diabetes, followed by Puerto Ricans, Cubans and other Latin American national roots.
Diabetes is a concern in the Latino community because it has been found that about 68 percent of those afflicted die from heart disease or stroke at an early age - that is two to four times higher than adults without diabetes. Smokers are especially vulnerable.
Preventing diabetes and minimizing its related complications is based on a self-managed effort, meaning any person afflicted with the disease must take personal responsibility for their day-to-day care. Adults at age 20 and older should at a minimum:
* Check glucose levels at least twice a year, ensuring that readings do not exceed 120 while fasting and 180 after meals;
* Check blood pressure levels at every doctor visit, ensuring pressure levels are maintained below 130/80; and,
* Check cholesterol levels at least once a year, ensuring levels of LDL do not exceed 200.
In addition, adults age 20 and older should ensure that:
* They lose 5 to 7 percent of their body weight (that equates to 10 to 40 pounds for a person who weighs 200 pounds and is clearly overweight;
* Be physically active for at least 30 minutes per day, 5 days a week (brisk walking for example); and,
* Enjoy healthier and natural foods, high in caloric values and protein, and low in refined sugars and enriched flour (the brighter the color, the healthier it is).
For more information about preventing and controlling diabetes, call 1-888-693- 6337 or visit the National Diabetes Education Program website at www.yourdiabetesinfo.org.
Thursday, August 20, 2009
Latino to run Valley Presbyterian Hospital
Valley Presbyterian Hospital Appoints New President and Chief Executive Officer
Business Wire, August 18, 2009
VAN NUYS, Calif.--(BUSINESS WIRE)--Valley Presbyterian Hospital (VPH) is pleased to announce the appointment of Gustavo Valdespino as President and Chief Executive Officer, effective September 1. Mr. Valdespino will succeed Albert L. Greene, who passed away in April 2009.
“Mr. Valdespino was chosen unanimously by a search committee through an intense and rigorous interview and selection process. He was judged to be bright, creative, passionate and charismatic with extraordinary people skills and a history of strong relations with both physicians and hospital staff,” said David Fleming, Chairman of the VPH Board of Directors. “The search committee selected an outstanding leader to carry on the mission and vision of Valley Pres."
Mr. Valdespino is a seasoned leader with more than 25 years of hospital management experience. He is widely known and respected in the Southern California hospital industry, having served as Senior Vice President of Operations for Tenet Health Corporation’s Southern California Region as well as the CEO of several hospitals. After leaving Tenet in 2003, Mr. Valdespino served as President and Chief Executive Officer of St. Vincent Medical Center in Los Angeles. For the past three years, Mr. Valdespino has served as Chief Executive Officer at Big Brothers Big Sisters of Orange County – a nationwide non-profit organization dedicated to providing one on one mentoring for children.
“I’m thrilled to return to hospital management during these exciting times in the health care industry. I was very impressed with the passion and commitment exhibited by the board members, physicians and senior executives that I met during the selection process. Valley Presbyterian Hospital has a strong tradition of meeting the health care needs of the surrounding community. I look forward to continuing that rich tradition in partnership with our board, medical staff and employees,” said Mr. Valdespino. “VPH has a culture of partnership and collaboration between the medical staff and administration, and I am honored to continue this partnership and to build upon the great work Al Greene accomplished at VPH.”
“As Valley Presbyterian moves forward with the appointment of Mr. Valdespino, I am confident that the future of this institution is in very good hands,” said Kamran Malek, M.D., Chief of the VPH Medical Staff. “I am particularly impressed with Mr. Valdespino’s commitment to open communication and effective relationships between the hospital and physicians.”
“I am confident that we found a stellar leader in Mr. Valdespino and I am certain he will preserve Al Greene’s legacy of growth and the provision of quality health care service for our diverse community,” said Gregory L. Kay, M.D. A member of the Valley Pres Board since 2006, Dr. Kay has served as Interim Chief Executive Officer of Valley Pres for the past three months while the search for a permanent CEO was underway.
Mr. Valdespino is active in both community and professional organizations and has served on numerous boards, such as the March of Dimes, the American Diabetes Association, and the Latino Business Association. He has also been a board member of the Blue Cross Hospital Relations Committee, the Federation of American Hospitals, the Healthcare Association of Southern California and the California Health Association.
In 1998, Mr. Valdespino received the “Up and Comer” Award from Modern Healthcare Magazine. He also received the National Medical Enterprises Circle of Excellence Award (1992-1993); the Tenet Healthcare Corporation Circle of Excellence Award (1996-1998); and the “Leading Hispanic Executive” Award from Hispanic Business Magazine, in 2001.
Mr. Valdespino holds a bachelor’s degree from the State University of New York at Stony Brook, a master’s degree in public health from the University of California, Los Angeles, and completed the Advanced Management Program at the Harvard Business School in Boston.
Mr. Valdespino and his wife, Rini Valdespino, have two children – Nicholas and Lauren.
Business Wire, August 18, 2009
VAN NUYS, Calif.--(BUSINESS WIRE)--Valley Presbyterian Hospital (VPH) is pleased to announce the appointment of Gustavo Valdespino as President and Chief Executive Officer, effective September 1. Mr. Valdespino will succeed Albert L. Greene, who passed away in April 2009.
“Mr. Valdespino was chosen unanimously by a search committee through an intense and rigorous interview and selection process. He was judged to be bright, creative, passionate and charismatic with extraordinary people skills and a history of strong relations with both physicians and hospital staff,” said David Fleming, Chairman of the VPH Board of Directors. “The search committee selected an outstanding leader to carry on the mission and vision of Valley Pres."
Mr. Valdespino is a seasoned leader with more than 25 years of hospital management experience. He is widely known and respected in the Southern California hospital industry, having served as Senior Vice President of Operations for Tenet Health Corporation’s Southern California Region as well as the CEO of several hospitals. After leaving Tenet in 2003, Mr. Valdespino served as President and Chief Executive Officer of St. Vincent Medical Center in Los Angeles. For the past three years, Mr. Valdespino has served as Chief Executive Officer at Big Brothers Big Sisters of Orange County – a nationwide non-profit organization dedicated to providing one on one mentoring for children.
“I’m thrilled to return to hospital management during these exciting times in the health care industry. I was very impressed with the passion and commitment exhibited by the board members, physicians and senior executives that I met during the selection process. Valley Presbyterian Hospital has a strong tradition of meeting the health care needs of the surrounding community. I look forward to continuing that rich tradition in partnership with our board, medical staff and employees,” said Mr. Valdespino. “VPH has a culture of partnership and collaboration between the medical staff and administration, and I am honored to continue this partnership and to build upon the great work Al Greene accomplished at VPH.”
“As Valley Presbyterian moves forward with the appointment of Mr. Valdespino, I am confident that the future of this institution is in very good hands,” said Kamran Malek, M.D., Chief of the VPH Medical Staff. “I am particularly impressed with Mr. Valdespino’s commitment to open communication and effective relationships between the hospital and physicians.”
“I am confident that we found a stellar leader in Mr. Valdespino and I am certain he will preserve Al Greene’s legacy of growth and the provision of quality health care service for our diverse community,” said Gregory L. Kay, M.D. A member of the Valley Pres Board since 2006, Dr. Kay has served as Interim Chief Executive Officer of Valley Pres for the past three months while the search for a permanent CEO was underway.
Mr. Valdespino is active in both community and professional organizations and has served on numerous boards, such as the March of Dimes, the American Diabetes Association, and the Latino Business Association. He has also been a board member of the Blue Cross Hospital Relations Committee, the Federation of American Hospitals, the Healthcare Association of Southern California and the California Health Association.
In 1998, Mr. Valdespino received the “Up and Comer” Award from Modern Healthcare Magazine. He also received the National Medical Enterprises Circle of Excellence Award (1992-1993); the Tenet Healthcare Corporation Circle of Excellence Award (1996-1998); and the “Leading Hispanic Executive” Award from Hispanic Business Magazine, in 2001.
Mr. Valdespino holds a bachelor’s degree from the State University of New York at Stony Brook, a master’s degree in public health from the University of California, Los Angeles, and completed the Advanced Management Program at the Harvard Business School in Boston.
Mr. Valdespino and his wife, Rini Valdespino, have two children – Nicholas and Lauren.
Tuesday, August 18, 2009
Latinos tackle alzheimer's
Latinos tackle Alzheimer’s
By Diana Montaño, jsonline.com, Aug. 17, 2009
When Eugenio Ramirez heads out to the Latino Geriatric Center each morning, he says he's going to the capital, San Juan, for the day. In the afternoon he says he's going home to Vega Alta, the small coastal village where he grew up.
Eugenio Ramirez Jr., the son he lives with in Milwaukee's Riverwest neighborhood, can't tell whether his father really thinks that he's still in Puerto Rico, the same way he can't tell whether he really thinks that he's 42 years old, or that Junior isn't his son, but his brother.
Ramirez, 94, who came to Wisconsin from Puerto Rico in 1966, was diagnosed with Alzheimer's disease four years ago. He's forgotten his English and the names of his eight children, but he remembers la isla, the island, as if he'd never left.
In a way, Ramirez really does visit the tropical homeland of his memories each weekday. Warm, pastel-colored walls, arched doorways, an artificial fountain in the middle of the main hallway, the smell of warm rice and beans - all give the Latino Geriatric Center the feel of a Latin American hometown, more than a day care center for elderly dementia patients on Milwaukee's near south side.
And that's not a coincidence. Seeing a need for accessible and culturally appropriate care for Latino elders with Alzheimer's and other forms of dementia, the United Community Center, a social services organization catering to Milwaukee's Latinos, opened the Latino Geriatric Center in 2007.
Alzheimer's disease is the most common form of dementia and the seventh-leading cause of death in the United States, according to the Centers for Disease Control and Prevention. The estimated 200,000 Latinos diagnosed with Alzheimer's make up a relatively small portion of the 5.3 million cases nationwide, but it's estimated that by 2050 that number could balloon to as much as 1.3 million, according to the Alzheimer's Association, a national organization focusing on Alzheimer's research and care.
Studies also suggest that the disease appears earlier in the Latino community - finding that, on average, Latinos develop the disease at 66 years old, compared with age 72 in non-Latinos.
But gaps in medical research, cultural and economic barriers to accurate diagnosis and treatment, and lack of information about the disease make it difficult to gauge its prevalence among Latinos, its effect on the community and the implications these disparities may have for prevention and care.
"Before the doctors told us she had Alzheimer's," said Paula Hernandez of her mother, Julia, who was diagnosed at 63 years old, "we didn't know anything about it. Zero."
Hernandez and her sister, Rosa Preciado, were at the Latino Geriatric Center on a recent morning with their mother for a workshop on diabetes, part of a monthly series the center organizes for its caregiver support group. The workshop made her think about the fact that her mother was diagnosed with diabetes years ago but wasn't treated until recently - a realization that is not insignificant.
Although the causes of Alzheimer's are still largely a medical mystery, experts have come to a general consensus on risk factors likely to trigger or accelerate the development of the disease. Among these are diabetes, vascular disease, low educational level, depression and stress, all of which affect the vitality of brain cells and memory retention.
Prevalence of these risk factors in the Latino population has experts looking at the health status of the community as one possible explanation for the anomaly of early onset.
"The differences are economic, social and cultural, not biological," said Piero Antuono, a professor of neurology at the Medical College of Wisconsin and director of the school's Dementia Research Center.
Racial diversity, he said, makes genetic factors less relevant to understanding the development of the disease in Latinos, whose biological makeup can include African, indigenous or European genes. Rather, he said, "it's about lifestyle, diet, access to medical care, access to healthy food."
Antuono is not alone in his thinking. Changes in diet and lifestyle experienced by Latinos who've arrived from another country or from Puerto Rico can have significant health effects.
"All countries are experiencing an increase in obesity," said Maria Carrillo, director of medical and scientific relations at the Alzheimer's Association. "But the U.S. leads in the game. So our lifestyle is going to come with risk factors. And for people coming in with lower socioeconomic status, and who are limited to certain neighborhoods, there's not a positive outcome."
According to the Office of Minority Health, Latinos' risk of developing diabetes is more than double that of non-Latino whites. This increases the risk of developing Alzheimer's or stroke-related dementia by two to three times, Carrillo said.
Students from the University of Wisconsin School of Medicine and Public Health conducted an informal survey of Alzheimer's and dementia patients at the Latino Geriatric Center and found that out of 89 patients, about 44% were diabetic.
Mental health disparities may also play a role. According to Carolina Zuñiga, who runs the center's Memory Clinic, there are only three Spanish-speaking psychiatrists in all of Milwaukee. This means less access to treatment of depression or anxiety disorders related to the migration experience itself or to social or cultural isolation. The Geriatric Center regularly refers clients to the United Community Center's "Nuevo Amanecer" ("New Sunrise") depression clinic for seniors, and nearly a quarter have been diagnosed with depression.
Because many of these risk factors are treatable and even preventable, health interventions such as screening and education are particularly significant. According to Carrillo, lifestyle changes can delay onset of Alzheimer's by three to five years. But implementing such interventions is hindered by a lack of information.
This year, the Wisconsin Alzheimer's Institute at UW-Madison partnered with the Geriatric Center to recruit Latino participants into its Wisconsin Registry for Alzheimer's Prevention, or WRAP, a long-term study tracking children of Alzheimer's patients to see whether they are more likely to develop the disease. One problem: While a simple test has been translated into Spanish and certified for the study, the same has not been done for the longer, more complex version.
"These tests require certain forms of language," said Mark Sager, director of the institute. The disparate dialects, expressions and cultural references used by Latinos from different countries, he said, make advanced cognition testing in Spanish-speaking elders a challenge.
"Take the word guagua," said Carlos Mejia, a WRAP participant who found the simplicity of the screening troubling. "For Puerto Ricans it means bus, but for Chileans it means baby. If you tell a Chilean that you're waiting on the corner for the guagua, they're not going to understand you."
A lack of scientific knowledge can lead to diagnostic, treatment or prevention efforts that are inadequate or inappropriate for underrepresented communities.
"It's important to address disparities in research," Carrillo said.
By Diana Montaño, jsonline.com, Aug. 17, 2009
When Eugenio Ramirez heads out to the Latino Geriatric Center each morning, he says he's going to the capital, San Juan, for the day. In the afternoon he says he's going home to Vega Alta, the small coastal village where he grew up.
Eugenio Ramirez Jr., the son he lives with in Milwaukee's Riverwest neighborhood, can't tell whether his father really thinks that he's still in Puerto Rico, the same way he can't tell whether he really thinks that he's 42 years old, or that Junior isn't his son, but his brother.
Ramirez, 94, who came to Wisconsin from Puerto Rico in 1966, was diagnosed with Alzheimer's disease four years ago. He's forgotten his English and the names of his eight children, but he remembers la isla, the island, as if he'd never left.
In a way, Ramirez really does visit the tropical homeland of his memories each weekday. Warm, pastel-colored walls, arched doorways, an artificial fountain in the middle of the main hallway, the smell of warm rice and beans - all give the Latino Geriatric Center the feel of a Latin American hometown, more than a day care center for elderly dementia patients on Milwaukee's near south side.
And that's not a coincidence. Seeing a need for accessible and culturally appropriate care for Latino elders with Alzheimer's and other forms of dementia, the United Community Center, a social services organization catering to Milwaukee's Latinos, opened the Latino Geriatric Center in 2007.
Alzheimer's disease is the most common form of dementia and the seventh-leading cause of death in the United States, according to the Centers for Disease Control and Prevention. The estimated 200,000 Latinos diagnosed with Alzheimer's make up a relatively small portion of the 5.3 million cases nationwide, but it's estimated that by 2050 that number could balloon to as much as 1.3 million, according to the Alzheimer's Association, a national organization focusing on Alzheimer's research and care.
Studies also suggest that the disease appears earlier in the Latino community - finding that, on average, Latinos develop the disease at 66 years old, compared with age 72 in non-Latinos.
But gaps in medical research, cultural and economic barriers to accurate diagnosis and treatment, and lack of information about the disease make it difficult to gauge its prevalence among Latinos, its effect on the community and the implications these disparities may have for prevention and care.
"Before the doctors told us she had Alzheimer's," said Paula Hernandez of her mother, Julia, who was diagnosed at 63 years old, "we didn't know anything about it. Zero."
Hernandez and her sister, Rosa Preciado, were at the Latino Geriatric Center on a recent morning with their mother for a workshop on diabetes, part of a monthly series the center organizes for its caregiver support group. The workshop made her think about the fact that her mother was diagnosed with diabetes years ago but wasn't treated until recently - a realization that is not insignificant.
Although the causes of Alzheimer's are still largely a medical mystery, experts have come to a general consensus on risk factors likely to trigger or accelerate the development of the disease. Among these are diabetes, vascular disease, low educational level, depression and stress, all of which affect the vitality of brain cells and memory retention.
Prevalence of these risk factors in the Latino population has experts looking at the health status of the community as one possible explanation for the anomaly of early onset.
"The differences are economic, social and cultural, not biological," said Piero Antuono, a professor of neurology at the Medical College of Wisconsin and director of the school's Dementia Research Center.
Racial diversity, he said, makes genetic factors less relevant to understanding the development of the disease in Latinos, whose biological makeup can include African, indigenous or European genes. Rather, he said, "it's about lifestyle, diet, access to medical care, access to healthy food."
Antuono is not alone in his thinking. Changes in diet and lifestyle experienced by Latinos who've arrived from another country or from Puerto Rico can have significant health effects.
"All countries are experiencing an increase in obesity," said Maria Carrillo, director of medical and scientific relations at the Alzheimer's Association. "But the U.S. leads in the game. So our lifestyle is going to come with risk factors. And for people coming in with lower socioeconomic status, and who are limited to certain neighborhoods, there's not a positive outcome."
According to the Office of Minority Health, Latinos' risk of developing diabetes is more than double that of non-Latino whites. This increases the risk of developing Alzheimer's or stroke-related dementia by two to three times, Carrillo said.
Students from the University of Wisconsin School of Medicine and Public Health conducted an informal survey of Alzheimer's and dementia patients at the Latino Geriatric Center and found that out of 89 patients, about 44% were diabetic.
Mental health disparities may also play a role. According to Carolina Zuñiga, who runs the center's Memory Clinic, there are only three Spanish-speaking psychiatrists in all of Milwaukee. This means less access to treatment of depression or anxiety disorders related to the migration experience itself or to social or cultural isolation. The Geriatric Center regularly refers clients to the United Community Center's "Nuevo Amanecer" ("New Sunrise") depression clinic for seniors, and nearly a quarter have been diagnosed with depression.
Because many of these risk factors are treatable and even preventable, health interventions such as screening and education are particularly significant. According to Carrillo, lifestyle changes can delay onset of Alzheimer's by three to five years. But implementing such interventions is hindered by a lack of information.
This year, the Wisconsin Alzheimer's Institute at UW-Madison partnered with the Geriatric Center to recruit Latino participants into its Wisconsin Registry for Alzheimer's Prevention, or WRAP, a long-term study tracking children of Alzheimer's patients to see whether they are more likely to develop the disease. One problem: While a simple test has been translated into Spanish and certified for the study, the same has not been done for the longer, more complex version.
"These tests require certain forms of language," said Mark Sager, director of the institute. The disparate dialects, expressions and cultural references used by Latinos from different countries, he said, make advanced cognition testing in Spanish-speaking elders a challenge.
"Take the word guagua," said Carlos Mejia, a WRAP participant who found the simplicity of the screening troubling. "For Puerto Ricans it means bus, but for Chileans it means baby. If you tell a Chilean that you're waiting on the corner for the guagua, they're not going to understand you."
A lack of scientific knowledge can lead to diagnostic, treatment or prevention efforts that are inadequate or inappropriate for underrepresented communities.
"It's important to address disparities in research," Carrillo said.
Latino health fair draws 1000
1,000 get update on health at Latino fair
Claudia Vargas – rocnow.com – August 17, 2009
With the loud Spanish music of a live band in the background, more than 1,000 people made their rounds at booths set up Sunday at the fifth annual Latino Health Fair held at Upper Falls Boulevard and Clinton Avenue.
The event, which was sponsored and organized by Rochester Primary Health Network, was meant to cater to the Latino community in Monroe County, but many non-Latinos attend each year, said health fair coordinator Marina Alvarez.
She added that the fair is geared to help the uninsured and underinsured and “those who fall between the cracks,” of the health-care system.
Not only are many Latinos part of those groups but they often do not know about services available to them because of a language barrier, she said.
Those who attended the fair were able to stop at any of the close to 80 booths set up to chat with representatives or pick up information on everything from diabetes to dental care.
Elizabeth Lopez, 39, of Rochester came to the health fair with her family because she has been able to get hooked up with health-related services from attending some of the previous fairs.
“With the economy now, it’s very helpful,” she said about finding affordable health care.
The event also gave families the opportunity to get their children Operation Safe Child ID cards, which have the child’s photo, fingerprints and physical description and are designed to be used in case a child is missing.
Another stop was the Unity Health System mobile truck where people could get tested for HIV and get their results right away.
Adalik Rivera, who was working at the HIV testing site, said the Latino community is an important group to reach out to because HIV is often not talked about.
“They are afraid to talk about it … it is still a taboo,” Rivera said.
CLVARGAS@DemocratandChronicle.com
Claudia Vargas – rocnow.com – August 17, 2009
With the loud Spanish music of a live band in the background, more than 1,000 people made their rounds at booths set up Sunday at the fifth annual Latino Health Fair held at Upper Falls Boulevard and Clinton Avenue.
The event, which was sponsored and organized by Rochester Primary Health Network, was meant to cater to the Latino community in Monroe County, but many non-Latinos attend each year, said health fair coordinator Marina Alvarez.
She added that the fair is geared to help the uninsured and underinsured and “those who fall between the cracks,” of the health-care system.
Not only are many Latinos part of those groups but they often do not know about services available to them because of a language barrier, she said.
Those who attended the fair were able to stop at any of the close to 80 booths set up to chat with representatives or pick up information on everything from diabetes to dental care.
Elizabeth Lopez, 39, of Rochester came to the health fair with her family because she has been able to get hooked up with health-related services from attending some of the previous fairs.
“With the economy now, it’s very helpful,” she said about finding affordable health care.
The event also gave families the opportunity to get their children Operation Safe Child ID cards, which have the child’s photo, fingerprints and physical description and are designed to be used in case a child is missing.
Another stop was the Unity Health System mobile truck where people could get tested for HIV and get their results right away.
Adalik Rivera, who was working at the HIV testing site, said the Latino community is an important group to reach out to because HIV is often not talked about.
“They are afraid to talk about it … it is still a taboo,” Rivera said.
CLVARGAS@DemocratandChronicle.com
Cancer incidence patterns identified in Hispanics
Cancer incidence patterns identified in Hispanics living in the United States
Hemonc Today, August 17, 2009
According to data from a recent study, first-generation Hispanics living in the United States have varying patterns of cancer diagnoses and outcome. The risk for most cancers was at least 40% higher among Hispanics living in the United States compared with those living in their homelands.
Using data from the Florida cancer registry and the 2000 U.S. Census population, the researchers identified 301,944 cancer cases in the state of Florida diagnosed between 1999 and 2001. They identified 30,238 Hispanic patients, including Cubans, Mexicans, Puerto Ricans and other Latinos. The researchers evaluated the types of cancers occurring in each group and compared their risk after moving to the United States.
The age-adjusted cancer incidence rate was lower for all Hispanic men compared with whites (537/100,000 person-years vs. 601/100,000 person-years). The same was true for Hispanic and white women (376/100,000 person-years vs. 460/100,000 person-years). Puerto Ricans had the highest cancer incidence rates, followed by Cubans; Mexicans had the lowest rates.
Among Hispanics, Cuban men had the highest incidence of tobacco-related cancers. Cuban men also had the highest rate of laryngeal cancer. Although Puerto Ricans had cancer incidence rates similar to rates in whites, rates of lung cancer and melanoma in both men and women and breast cancer in women were much lower in Puerto Ricans than in whites.
Lung cancer rates were four-times higher in Mexican and Puerto Rican women compared with the rates of Hispanics living in their countries of origin. The rates were doubled in Mexican and Puerto Rican men. However, Hispanics in their home countries had higher incidences of stomach cancer in both men and women and liver cancer in women.
“Knowledge of cancer patterns in these subpopulations is vital,” the researchers wrote. “These data influence public health policy and form the basis of etiologic hypotheses.”
In addition, the researchers wrote that their findings should be further investigated.
Pinheiro PS. Cancer Epidemiol Biomarkers Prev. 2009;18:2162-2169.
Hemonc Today, August 17, 2009
According to data from a recent study, first-generation Hispanics living in the United States have varying patterns of cancer diagnoses and outcome. The risk for most cancers was at least 40% higher among Hispanics living in the United States compared with those living in their homelands.
Using data from the Florida cancer registry and the 2000 U.S. Census population, the researchers identified 301,944 cancer cases in the state of Florida diagnosed between 1999 and 2001. They identified 30,238 Hispanic patients, including Cubans, Mexicans, Puerto Ricans and other Latinos. The researchers evaluated the types of cancers occurring in each group and compared their risk after moving to the United States.
The age-adjusted cancer incidence rate was lower for all Hispanic men compared with whites (537/100,000 person-years vs. 601/100,000 person-years). The same was true for Hispanic and white women (376/100,000 person-years vs. 460/100,000 person-years). Puerto Ricans had the highest cancer incidence rates, followed by Cubans; Mexicans had the lowest rates.
Among Hispanics, Cuban men had the highest incidence of tobacco-related cancers. Cuban men also had the highest rate of laryngeal cancer. Although Puerto Ricans had cancer incidence rates similar to rates in whites, rates of lung cancer and melanoma in both men and women and breast cancer in women were much lower in Puerto Ricans than in whites.
Lung cancer rates were four-times higher in Mexican and Puerto Rican women compared with the rates of Hispanics living in their countries of origin. The rates were doubled in Mexican and Puerto Rican men. However, Hispanics in their home countries had higher incidences of stomach cancer in both men and women and liver cancer in women.
“Knowledge of cancer patterns in these subpopulations is vital,” the researchers wrote. “These data influence public health policy and form the basis of etiologic hypotheses.”
In addition, the researchers wrote that their findings should be further investigated.
Pinheiro PS. Cancer Epidemiol Biomarkers Prev. 2009;18:2162-2169.
Monday, August 17, 2009
Latino children excessively exposed to pesticides
A drifting danger for Central Valley schoolchildren
Despite regulations and laws to protect children, Fresno County authorities say school buses are still being exposed to pesticide clouds once or twice a year.
By Amy Littlefield, LA Times, August 16, 2009
Nancy and Bryan Lara, ages 10 and 8, knew something was wrong when they saw a tractor surrounded by white clouds near their school bus stop in Caruthers.
"I know that clouds are not on the ground, they're in the sky," Bryan said.
The children hid behind a row of grapevines, but they could taste the noxious blend of liquid sulfur, gibberellic acid, insecticide and fertilizer as the rig rolled past them, billowing out its chemical cargo.
Moments earlier, the mist had enveloped 17-year-old Carina at another stop about two blocks away.
"I felt it. It was wet. I was wet," said Carina, who asked that her last name not be used.
School bus driver Crystal Wells drove up in time to see Nancy and Bryan running for cover. She pulled her bus to the side of the road to avoid exposure. Her decision kept 50 children from being exposed.
The May 14 incident was the third case in seven months in which San Joaquin Valley children were exposed to pesticides while at stops or on school buses. Despite regulations and laws in place to protect children, including programs to encourage growers to be aware of school bus routes, authorities estimate that school buses are still drifted on once or twice a year in Fresno County alone.
Though relatively rare, such incidents remain a reminder of the daily hazards of life in California's agricultural hub.
"Children are almost like a different species in terms of how they metabolize," said Nina Holland, the lead researcher of a UC Berkeley study that found children are more susceptible than adults to organophosphate pesticides. "We are talking about a very significant difference. We really need to look at protecting children."
Kryocide, the chemical that the children were sprayed with, is not an organophosphate. It is "slightly toxic if inhaled" and can damage a person's kidneys and bones if they are repeatedly exposed to it, according to a manufacturer's information sheet.
But what happened next shows how pesticide exposure can cause more than physical harm.
The bus driver picked up the three children, called her supervisor and drove them to Caruthers High School, where they were met by firefighters, medics and investigators. Soon, the three began to suffer headaches, nausea, itchiness and breathing difficulties.
Erika Lara arrived to find her two children hooked up to oxygen.
"I cried because they had oxygen on," Lara said. "I wasn't expecting that."
The mother's first instinct was to hug her children. The chemicals on their clothing made her arm red and itchy, she said.
All three children were escorted to showers and told to change into clean clothes. But investigators never collected the contaminated clothing, saying the children's father refused to give them the samples. Francisco Lara said he was never asked for the clothes.
After showering, the children were taken to the hospital. They were released by late afternoon.
The event has left a strong impression on the Lara children.
"They saw my brother and me and they never stopped the tractor," Nancy said. "They don't care if they get on us and they don't have to pay the cost."
Such feelings are typical in cases of pesticide exposure, according to Gina Solomon, a physician and scientist with the Natural Resources Defense Council.
"Sometimes the anger and fear and anxiety of being exposed to a potentially toxic chemical against your will is as bad as the effects of the chemical or even worse," Solomon said.
When asked if he felt angry, Bryan Lara nodded. "I wanted to beat them up," he said.
According to a sheriff's report, the man Fresno County Sheriff's officials identified as the tractor driver, Manuel Medeiros, said he did not see any children.
Medeiros declined to respond to questions for this article. He could be fined between $250 and $5,000 per person exposed.
Without clothing samples, the investigation will rely on chemical tests of surface and plant samples collected at the bus stop.
The agricultural commissioner will make the final decision on whether to levy a fine and how much it should be.
Some believe the fines aren't enough.
"The fines are so small that they don't deter the growers," said Teresa DeAnda, an activist with Californians for Pesticide Reform. "The growers just see it as a cost of business."
Growers say they are careful to avoid exposing people.
"We definitely do not like any kind of drift situations where it's affecting human beings, or an animal even," said Nat DiBuduo, president of the Fresno-based Allied Grape Growers, an association that represents about 600 California growers. He said the incident in Caruthers was "rare and unacceptable."
Fresno County has seen a decline in the number of children exposed to pesticides during the last decade, said Deputy Agricultural Commissioner Karen Francone, because of county efforts to teach bus drivers to pull over when they see rigs and to encourage growers to contact transportation authorities before they spray. But even armed with education, some growers still break the law.
On average, more than 30 million pounds of pesticides per year were applied to Fresno County fields alone from 2005 to 2007. The area is home to some of the worst air quality in the nation, in part because pesticides react with the air to form smog, some scientists say. About one in three children ages 5 to 17 in the county have asthma, according to a 2008 state analysis.
"It's in these small rural communities where it's occurring, where nobody is watching," said Daniela Simunovic, a community organizer with the Center on Race, Poverty and the Environment. "These kids are some of the most vulnerable people in our society. It's low-income communities of color that are bearing the brunt of a corporate agribusiness that has become so dependent on pesticides to make their profit."
Simunovic said there is a disconnect for supermarket shoppers in Los Angeles about the food they buy and its origins. But people who live near the orchards and fields are all too familiar with the human cost of cheap produce.
"It's just become something normal for everyone here in the Central Valley," Wells said. "We just assume that we're going to walk out one day and get sprayed, or the tractor is going to be there."
Carina, who was exposed in Caruthers, said the incident didn't seem out of the ordinary. "I thought it was normal," she said. "I didn't want no problems, nothing like that."
DeAnda, who started organizing for safer pesticide use 10 years ago when a met- am sodium drift sickened dozens in her town of Earlimart, north of Bakersfield, counsels residents to turn that atti- tude into coraje, or right- eous indignation, and then into action.
Erika Lara is part of the way there.
"You have to respect people, the children most of all," Lara said, looking down at her toes and then out at her backyard and the fence that separates it from rows and rows of leafy, green vines.
Between the fence and the home is the children's trampoline, where they are spending the summer jumping, taking breaks to douse themselves with water in the stifling Valley heat.
When asked where she and her brother like to play, Nancy gestures out across the vineyards. They play tag between the rows, she said. They bring water out to the field and they cover themselves with mud. And when they see a tractor coming, they run for cover.
amy.littlefield@latimes.com
Despite regulations and laws to protect children, Fresno County authorities say school buses are still being exposed to pesticide clouds once or twice a year.
By Amy Littlefield, LA Times, August 16, 2009
Nancy and Bryan Lara, ages 10 and 8, knew something was wrong when they saw a tractor surrounded by white clouds near their school bus stop in Caruthers.
"I know that clouds are not on the ground, they're in the sky," Bryan said.
The children hid behind a row of grapevines, but they could taste the noxious blend of liquid sulfur, gibberellic acid, insecticide and fertilizer as the rig rolled past them, billowing out its chemical cargo.
Moments earlier, the mist had enveloped 17-year-old Carina at another stop about two blocks away.
"I felt it. It was wet. I was wet," said Carina, who asked that her last name not be used.
School bus driver Crystal Wells drove up in time to see Nancy and Bryan running for cover. She pulled her bus to the side of the road to avoid exposure. Her decision kept 50 children from being exposed.
The May 14 incident was the third case in seven months in which San Joaquin Valley children were exposed to pesticides while at stops or on school buses. Despite regulations and laws in place to protect children, including programs to encourage growers to be aware of school bus routes, authorities estimate that school buses are still drifted on once or twice a year in Fresno County alone.
Though relatively rare, such incidents remain a reminder of the daily hazards of life in California's agricultural hub.
"Children are almost like a different species in terms of how they metabolize," said Nina Holland, the lead researcher of a UC Berkeley study that found children are more susceptible than adults to organophosphate pesticides. "We are talking about a very significant difference. We really need to look at protecting children."
Kryocide, the chemical that the children were sprayed with, is not an organophosphate. It is "slightly toxic if inhaled" and can damage a person's kidneys and bones if they are repeatedly exposed to it, according to a manufacturer's information sheet.
But what happened next shows how pesticide exposure can cause more than physical harm.
The bus driver picked up the three children, called her supervisor and drove them to Caruthers High School, where they were met by firefighters, medics and investigators. Soon, the three began to suffer headaches, nausea, itchiness and breathing difficulties.
Erika Lara arrived to find her two children hooked up to oxygen.
"I cried because they had oxygen on," Lara said. "I wasn't expecting that."
The mother's first instinct was to hug her children. The chemicals on their clothing made her arm red and itchy, she said.
All three children were escorted to showers and told to change into clean clothes. But investigators never collected the contaminated clothing, saying the children's father refused to give them the samples. Francisco Lara said he was never asked for the clothes.
After showering, the children were taken to the hospital. They were released by late afternoon.
The event has left a strong impression on the Lara children.
"They saw my brother and me and they never stopped the tractor," Nancy said. "They don't care if they get on us and they don't have to pay the cost."
Such feelings are typical in cases of pesticide exposure, according to Gina Solomon, a physician and scientist with the Natural Resources Defense Council.
"Sometimes the anger and fear and anxiety of being exposed to a potentially toxic chemical against your will is as bad as the effects of the chemical or even worse," Solomon said.
When asked if he felt angry, Bryan Lara nodded. "I wanted to beat them up," he said.
According to a sheriff's report, the man Fresno County Sheriff's officials identified as the tractor driver, Manuel Medeiros, said he did not see any children.
Medeiros declined to respond to questions for this article. He could be fined between $250 and $5,000 per person exposed.
Without clothing samples, the investigation will rely on chemical tests of surface and plant samples collected at the bus stop.
The agricultural commissioner will make the final decision on whether to levy a fine and how much it should be.
Some believe the fines aren't enough.
"The fines are so small that they don't deter the growers," said Teresa DeAnda, an activist with Californians for Pesticide Reform. "The growers just see it as a cost of business."
Growers say they are careful to avoid exposing people.
"We definitely do not like any kind of drift situations where it's affecting human beings, or an animal even," said Nat DiBuduo, president of the Fresno-based Allied Grape Growers, an association that represents about 600 California growers. He said the incident in Caruthers was "rare and unacceptable."
Fresno County has seen a decline in the number of children exposed to pesticides during the last decade, said Deputy Agricultural Commissioner Karen Francone, because of county efforts to teach bus drivers to pull over when they see rigs and to encourage growers to contact transportation authorities before they spray. But even armed with education, some growers still break the law.
On average, more than 30 million pounds of pesticides per year were applied to Fresno County fields alone from 2005 to 2007. The area is home to some of the worst air quality in the nation, in part because pesticides react with the air to form smog, some scientists say. About one in three children ages 5 to 17 in the county have asthma, according to a 2008 state analysis.
"It's in these small rural communities where it's occurring, where nobody is watching," said Daniela Simunovic, a community organizer with the Center on Race, Poverty and the Environment. "These kids are some of the most vulnerable people in our society. It's low-income communities of color that are bearing the brunt of a corporate agribusiness that has become so dependent on pesticides to make their profit."
Simunovic said there is a disconnect for supermarket shoppers in Los Angeles about the food they buy and its origins. But people who live near the orchards and fields are all too familiar with the human cost of cheap produce.
"It's just become something normal for everyone here in the Central Valley," Wells said. "We just assume that we're going to walk out one day and get sprayed, or the tractor is going to be there."
Carina, who was exposed in Caruthers, said the incident didn't seem out of the ordinary. "I thought it was normal," she said. "I didn't want no problems, nothing like that."
DeAnda, who started organizing for safer pesticide use 10 years ago when a met- am sodium drift sickened dozens in her town of Earlimart, north of Bakersfield, counsels residents to turn that atti- tude into coraje, or right- eous indignation, and then into action.
Erika Lara is part of the way there.
"You have to respect people, the children most of all," Lara said, looking down at her toes and then out at her backyard and the fence that separates it from rows and rows of leafy, green vines.
Between the fence and the home is the children's trampoline, where they are spending the summer jumping, taking breaks to douse themselves with water in the stifling Valley heat.
When asked where she and her brother like to play, Nancy gestures out across the vineyards. They play tag between the rows, she said. They bring water out to the field and they cover themselves with mud. And when they see a tractor coming, they run for cover.
amy.littlefield@latimes.com
Hispanics in New Orleans hurt for healthcare
Hispanics in New Orleans are hurting for health care
By Amber Sandoval-Griffin, The Times-Picayune, August 15, 2009
When Francisco Ramirez noticed an abnormal growth and skin irritation on his leg, he went to Tulane Medical Center's emergency room to get help. After some confusion, he says, he left no better off.
Although the 45-year-old native Honduran spoke broken English, a communication gap proved big enough that medical workers told him they couldn't help, he recalls from the episode two years ago.
"I couldn't get help because I didn't speak English very well and they didn't speak Spanish," Ramirez said.
A few days after his visit to the downtown hospital, Ramirez came across a mobile health clinic across the street from the Lowe's building supply store on Elysian Fields Avenue. A nurse practitioner at the clinic, offered by Common Ground Health Clinic's Latino Health Outreach Project, told him he had a fungus on his leg and gave medicine to treat it.
The immigrant construction worker, supporting a wife and 3-month-old child, hasn't seen a doctor for a checkup since his visit to the mobile clinic, saying he expects another medical setting to bring more hassle.
Tulane Medical Center officials note that they serve many Hispanics and, with language interpretation available for years at the downtown ER, don't know how the service breakdown reported by Ramirez could have happened. But the immigrant's experiences sound quite familiar to advocates for Hispanics in New Orleans.
Ramirez is one of large numbers of Hispanics -- many of them drawn to the area by rebuilding jobs after Hurricane Katrina -- who say they face several hurdles in obtaining medical care.
Vulnerable population
Like other working-class or low-income people, immigrant Hispanics are troubled by limited public transit options and lack of money for out-of-pocket fees. But they face additional problems that arguably make them the metro area's most vulnerable population, medically speaking: language barriers, exceptionally low rates of medical insurance coverage, and their own anxiety in providing personal information to medical providers -- out of fear that it could lead to closer scrutiny of their legal status in America.
"We anticipate that they are going to have language issues, we anticipate that they are going to have transportation issues," said Antor Ndep, executive director of the Common Ground Health Clinic, a facility in Algiers that provides free primary and preventive care and has a clientele that is about 10 percent Hispanic.
Dr. Jaime Bustamante, medical director of an international services department at Ochsner Foundation Hospital, said emergency rooms are rife with Hispanic patients who, lacking any relationship with a doctor, appear with urgent and nonurgent needs. Some of them are undocumented, and they require a sophisticated response, he said.
"The use of ER for non-ER care has created a backup in the system," he said. "We don't turn anybody down ... We do our best to treat their medical needs."
New Orleans has counted Spanish-speaking immigrants among its citizens since colonial days, with a Cuban presence reaching back generations and Central American and Mexican natives making inroads more recently -- especially since Hurricane Katrina in 2005. But there are no reliable estimates of how many local Hispanics might be lacking medical care.
As of 2007, about 9 percent of Jefferson Parish residents and 4 percent of Orleans Parish residents identified themselves as Hispanic or Latino, according to sample surveys by the U.S. Census Bureau. But experts say such surveys don't account for many undocumented Hispanic workers and their relatives.
Lost in translation
The most prevalent obstacle for Spanish speakers seeking medical care is the language barrier. This gap is frequently seen at the front desk of a hospital or on the phone when someone tries to book an appointment -- and is cut off immediately because the receptionist doesn't understand them.
Beyond the front desk, access to trained medical interpreters also is a major hurdle as patients try to explain their needs in Spanish. Although many facilities have bilingual staff members, experts say that's not the same as having an interpreter who specializes in conveying the patient's needs to the physician or nurse.
Among seven major hospitals in the metro area with emergency rooms, four offer medical interpreters on site, at least during regular office hours. The remaining three rely on an interpreter phone line. But miscommunication is a risk with such phone lines, and they prevent more nuanced exchanges between patients and doctors, some say.
"What we are finding in the city of New Orleans, specifically in hospitals, is that they are hard-pressed to find even someone who speaks Spanish who works in the office," said Daesy Berhorst, a volunteer with the Language Access Coalition. "So what we see a lot is someone who is not related at all to the health field, not a doctor or a nurse, who is now intervening and interpreting for someone about their health care." Some patients bring in their children to try to interpret, she said.
"That's probably not the best situation for the child to be in," Berhorst said. "There are certain cases where the mother has cancer, for instance."
Insurance scarce
In addition to the language barrier, a lack of medical insurance poses a challenge, for medical providers as well as patients. It is a national problem: According to an analysis of 2008 census data by the Kaiser Commission on Medicaid and the Urban Institute, Hispanics comprise 15 percent of the population but make up 32 percent of the total uninsured population in the United States. And health officials say such numbers ring true in New Orleans.
Also, many Hispanics in New Orleans work in transient construction jobs that typically do not offer medical insurance. Out-of-pocket fees usually charged by clinics, even on a sliding scale, prompt many to avoid preventive care visits.
Even when Hispanic patients find out about free or low-cost clinics that have bilingual staff members -- as in the case of Common Ground and Daughters of Charity clinics -- transportation is a hurdle. Many immigrants do not have a valid driver's license or a car and must rely on public transit services that remain drastically reduced from pre-Katrina levels.
Many undocumented Hispanics, meanwhile, view health workers as authority figures and fear that their personal information could be reported to immigration officials -- perhaps leading to deportations. Health workers say the fear is unjustified; nevertheless, it is common for Hispanics new to the area to provide false identification or incorrect addresses to health care providers. And that gets in the way of communication about follow-up treatment.
"I think there is a real fear," said Deborah Even, a nurse and care manager at the Daughters of Charity Services in Metairie. "Until they find out from someone or at a health fair or through a church that Daughters of Charity and other clinics in the city exist and are not going to ask them for legal status, they are scared of going to the doctor."
Multiple barriers
More than one issue often is at play when a working-class Hispanic family runs into obstacles with medical care.
Guadalupe Garcia, a native of Honduras, immigrated to New Orleans in 2003. That same year, she experienced intense pain in her hips. She sought out help at LSU Interim Public Hospital's emergency room.
There, she said, she was unable to explain her symptoms in English to a doctor who couldn't speak Spanish. Her son, 8 years old at the time, tried to explain her discomfort to the doctor in broken English. But Garcia, 39, said she never found out why she was in pain because she couldn't understand the doctor's responses, even with her son's help.
Garcia later found trained language interpreters at Daughters of Charity in Metairie, which provides services on a sliding scale. Now her greatest obstacle is getting to the clinic, a 30-minute ride, because she doesn't drive. As a mother of two teenage sons and a 22-month-old child, Garcia works from home as a caterer for construction sites, while her husband works long hours as a mechanic.
She must plan her doctor visits long in advance, and sometimes they can take up the majority of her day.
"At times it's very inconvenient," she said. "I'm always calling and calling for someone to drive me."
Daughters of Charity has three clinics in the area, including the St. Cecilia Medical Center in the Bywater neighborhood of New Orleans, but Even said transportation remains a huge issue for her patients.
Common Ground Health Clinic has developed a partial solution to the transportation problem by providing a mobile clinic a few days each month at day-labor pickup sites, such as the Elysian Fields location. The clinic, when available, arrives with Spanish-speaking medical interpreters.
The mobile clinic reaches out to male laborers who, usually young and in robust condition, won't look for a doctor unless they are in dire need.
Hoping to stay healthy
Mario Cerrato, 33, a Honduran immigrant with expertise as a welder, came to New Orleans weeks ago after living in Chicago for nine years. He waited one day at the corner of South Claiborne Avenue and Martin Luther King Boulevard in Central City, hoping to be chosen for construction work. It is there that Common Ground's mobile clinic usually sets up on Thursdays.
Cerrato has a constant reminder of what might happen should he need medical help. A friend from Honduras who lives with him recently broke his ankle while working construction. The friend, he said, won't go to the doctor because he doesn't speak English and doesn't know where to find a free clinic. The friend is laid up, trying to heal without medical help.
"He don't want to go there (to the doctor) because he will have to pay and the emergency room is such a hassle," Cerrato said.
As for Cerrato, who has no medical insurance and has yet to visit the mobile clinic, said if he gets sick or hurt, he doesn't know what he will do.
"How am I going to pay for it?" he said. "It's going to be difficult because at this time I don't have a job. I don't have transportation either, and the public transportation here is bad.
"It's going to be very difficult. So for now, I just hope I stay healthy."
Amber Sandoval-Griffin can be reached at asandoval-griffin@timespicayune.com.
By Amber Sandoval-Griffin, The Times-Picayune, August 15, 2009
When Francisco Ramirez noticed an abnormal growth and skin irritation on his leg, he went to Tulane Medical Center's emergency room to get help. After some confusion, he says, he left no better off.
Although the 45-year-old native Honduran spoke broken English, a communication gap proved big enough that medical workers told him they couldn't help, he recalls from the episode two years ago.
"I couldn't get help because I didn't speak English very well and they didn't speak Spanish," Ramirez said.
A few days after his visit to the downtown hospital, Ramirez came across a mobile health clinic across the street from the Lowe's building supply store on Elysian Fields Avenue. A nurse practitioner at the clinic, offered by Common Ground Health Clinic's Latino Health Outreach Project, told him he had a fungus on his leg and gave medicine to treat it.
The immigrant construction worker, supporting a wife and 3-month-old child, hasn't seen a doctor for a checkup since his visit to the mobile clinic, saying he expects another medical setting to bring more hassle.
Tulane Medical Center officials note that they serve many Hispanics and, with language interpretation available for years at the downtown ER, don't know how the service breakdown reported by Ramirez could have happened. But the immigrant's experiences sound quite familiar to advocates for Hispanics in New Orleans.
Ramirez is one of large numbers of Hispanics -- many of them drawn to the area by rebuilding jobs after Hurricane Katrina -- who say they face several hurdles in obtaining medical care.
Vulnerable population
Like other working-class or low-income people, immigrant Hispanics are troubled by limited public transit options and lack of money for out-of-pocket fees. But they face additional problems that arguably make them the metro area's most vulnerable population, medically speaking: language barriers, exceptionally low rates of medical insurance coverage, and their own anxiety in providing personal information to medical providers -- out of fear that it could lead to closer scrutiny of their legal status in America.
"We anticipate that they are going to have language issues, we anticipate that they are going to have transportation issues," said Antor Ndep, executive director of the Common Ground Health Clinic, a facility in Algiers that provides free primary and preventive care and has a clientele that is about 10 percent Hispanic.
Dr. Jaime Bustamante, medical director of an international services department at Ochsner Foundation Hospital, said emergency rooms are rife with Hispanic patients who, lacking any relationship with a doctor, appear with urgent and nonurgent needs. Some of them are undocumented, and they require a sophisticated response, he said.
"The use of ER for non-ER care has created a backup in the system," he said. "We don't turn anybody down ... We do our best to treat their medical needs."
New Orleans has counted Spanish-speaking immigrants among its citizens since colonial days, with a Cuban presence reaching back generations and Central American and Mexican natives making inroads more recently -- especially since Hurricane Katrina in 2005. But there are no reliable estimates of how many local Hispanics might be lacking medical care.
As of 2007, about 9 percent of Jefferson Parish residents and 4 percent of Orleans Parish residents identified themselves as Hispanic or Latino, according to sample surveys by the U.S. Census Bureau. But experts say such surveys don't account for many undocumented Hispanic workers and their relatives.
Lost in translation
The most prevalent obstacle for Spanish speakers seeking medical care is the language barrier. This gap is frequently seen at the front desk of a hospital or on the phone when someone tries to book an appointment -- and is cut off immediately because the receptionist doesn't understand them.
Beyond the front desk, access to trained medical interpreters also is a major hurdle as patients try to explain their needs in Spanish. Although many facilities have bilingual staff members, experts say that's not the same as having an interpreter who specializes in conveying the patient's needs to the physician or nurse.
Among seven major hospitals in the metro area with emergency rooms, four offer medical interpreters on site, at least during regular office hours. The remaining three rely on an interpreter phone line. But miscommunication is a risk with such phone lines, and they prevent more nuanced exchanges between patients and doctors, some say.
"What we are finding in the city of New Orleans, specifically in hospitals, is that they are hard-pressed to find even someone who speaks Spanish who works in the office," said Daesy Berhorst, a volunteer with the Language Access Coalition. "So what we see a lot is someone who is not related at all to the health field, not a doctor or a nurse, who is now intervening and interpreting for someone about their health care." Some patients bring in their children to try to interpret, she said.
"That's probably not the best situation for the child to be in," Berhorst said. "There are certain cases where the mother has cancer, for instance."
Insurance scarce
In addition to the language barrier, a lack of medical insurance poses a challenge, for medical providers as well as patients. It is a national problem: According to an analysis of 2008 census data by the Kaiser Commission on Medicaid and the Urban Institute, Hispanics comprise 15 percent of the population but make up 32 percent of the total uninsured population in the United States. And health officials say such numbers ring true in New Orleans.
Also, many Hispanics in New Orleans work in transient construction jobs that typically do not offer medical insurance. Out-of-pocket fees usually charged by clinics, even on a sliding scale, prompt many to avoid preventive care visits.
Even when Hispanic patients find out about free or low-cost clinics that have bilingual staff members -- as in the case of Common Ground and Daughters of Charity clinics -- transportation is a hurdle. Many immigrants do not have a valid driver's license or a car and must rely on public transit services that remain drastically reduced from pre-Katrina levels.
Many undocumented Hispanics, meanwhile, view health workers as authority figures and fear that their personal information could be reported to immigration officials -- perhaps leading to deportations. Health workers say the fear is unjustified; nevertheless, it is common for Hispanics new to the area to provide false identification or incorrect addresses to health care providers. And that gets in the way of communication about follow-up treatment.
"I think there is a real fear," said Deborah Even, a nurse and care manager at the Daughters of Charity Services in Metairie. "Until they find out from someone or at a health fair or through a church that Daughters of Charity and other clinics in the city exist and are not going to ask them for legal status, they are scared of going to the doctor."
Multiple barriers
More than one issue often is at play when a working-class Hispanic family runs into obstacles with medical care.
Guadalupe Garcia, a native of Honduras, immigrated to New Orleans in 2003. That same year, she experienced intense pain in her hips. She sought out help at LSU Interim Public Hospital's emergency room.
There, she said, she was unable to explain her symptoms in English to a doctor who couldn't speak Spanish. Her son, 8 years old at the time, tried to explain her discomfort to the doctor in broken English. But Garcia, 39, said she never found out why she was in pain because she couldn't understand the doctor's responses, even with her son's help.
Garcia later found trained language interpreters at Daughters of Charity in Metairie, which provides services on a sliding scale. Now her greatest obstacle is getting to the clinic, a 30-minute ride, because she doesn't drive. As a mother of two teenage sons and a 22-month-old child, Garcia works from home as a caterer for construction sites, while her husband works long hours as a mechanic.
She must plan her doctor visits long in advance, and sometimes they can take up the majority of her day.
"At times it's very inconvenient," she said. "I'm always calling and calling for someone to drive me."
Daughters of Charity has three clinics in the area, including the St. Cecilia Medical Center in the Bywater neighborhood of New Orleans, but Even said transportation remains a huge issue for her patients.
Common Ground Health Clinic has developed a partial solution to the transportation problem by providing a mobile clinic a few days each month at day-labor pickup sites, such as the Elysian Fields location. The clinic, when available, arrives with Spanish-speaking medical interpreters.
The mobile clinic reaches out to male laborers who, usually young and in robust condition, won't look for a doctor unless they are in dire need.
Hoping to stay healthy
Mario Cerrato, 33, a Honduran immigrant with expertise as a welder, came to New Orleans weeks ago after living in Chicago for nine years. He waited one day at the corner of South Claiborne Avenue and Martin Luther King Boulevard in Central City, hoping to be chosen for construction work. It is there that Common Ground's mobile clinic usually sets up on Thursdays.
Cerrato has a constant reminder of what might happen should he need medical help. A friend from Honduras who lives with him recently broke his ankle while working construction. The friend, he said, won't go to the doctor because he doesn't speak English and doesn't know where to find a free clinic. The friend is laid up, trying to heal without medical help.
"He don't want to go there (to the doctor) because he will have to pay and the emergency room is such a hassle," Cerrato said.
As for Cerrato, who has no medical insurance and has yet to visit the mobile clinic, said if he gets sick or hurt, he doesn't know what he will do.
"How am I going to pay for it?" he said. "It's going to be difficult because at this time I don't have a job. I don't have transportation either, and the public transportation here is bad.
"It's going to be very difficult. So for now, I just hope I stay healthy."
Amber Sandoval-Griffin can be reached at asandoval-griffin@timespicayune.com.
Sunday, August 16, 2009
Latino health fair draws hundreds
Latino health fair draws hundreds
WKOW TV, Aug 15, 2009
OREGON (WKOW) -- It was a chance for hundreds of uninsured and under-insured hispanics in Dane County to get a check-up on their health.
The Oregon Sports and Fitness Club hosted the 11th Annual Latino Health Fair.
Forty exhibitors, from clinics to insurance companies, educated people about the health care system.
There were also chances for free screenings for conditions like high cholesterol, glaucoma, and HIV.
"So a whole set of screening exams for people who don't have access to maybe those exams through insurance or other means," said Shiva Bidar-Sielaff, the co-chair of the Latino Health Council.
The theme of Saturday's fair was "Obesity and Health Lifestyles."
Also there was Congresswoman Tammy Baldwin (D-Madison), who has worked in recent weeks in Washington, D.C. on health care reform proposals.
While organizers wouldn't take a position on specific reform ideas, Bidar-Sielaff said the turnout for the event shows many people are finding themselves left out from access to health care, especially for groups like Dane County's emerging hispanic community.
"People are new immigrants in the community, so they really don't understand how you go about accessing the health care system here in the United States, so this is often kind of a first place for people to find out information about the health care system in the U.S.," she said.
WKOW TV, Aug 15, 2009
OREGON (WKOW) -- It was a chance for hundreds of uninsured and under-insured hispanics in Dane County to get a check-up on their health.
The Oregon Sports and Fitness Club hosted the 11th Annual Latino Health Fair.
Forty exhibitors, from clinics to insurance companies, educated people about the health care system.
There were also chances for free screenings for conditions like high cholesterol, glaucoma, and HIV.
"So a whole set of screening exams for people who don't have access to maybe those exams through insurance or other means," said Shiva Bidar-Sielaff, the co-chair of the Latino Health Council.
The theme of Saturday's fair was "Obesity and Health Lifestyles."
Also there was Congresswoman Tammy Baldwin (D-Madison), who has worked in recent weeks in Washington, D.C. on health care reform proposals.
While organizers wouldn't take a position on specific reform ideas, Bidar-Sielaff said the turnout for the event shows many people are finding themselves left out from access to health care, especially for groups like Dane County's emerging hispanic community.
"People are new immigrants in the community, so they really don't understand how you go about accessing the health care system here in the United States, so this is often kind of a first place for people to find out information about the health care system in the U.S.," she said.
Saturday, August 15, 2009
Dermatologists target Hispanics nationwide
Rodan + Fields Dermatologists Launch National Hispanic Outreach Campaign
PRESS RELEASE
SAN FRANCISCO, Aug. 14 /PRNewswire/ -- Rodan + Fields Dermatologists, the clinical skincare brand developed by Stanford University-trained dermatologists Katie Rodan, M.D. and Kathy Fields, M.D., announce the brand's official entrance into the Hispanic market. Through a variety of Spanish language initiatives, Rodan + Fields will bring the dermatologic knowledge and skincare expertise of Dr. Rodan and Dr. Fields to the Hispanic community, offering an exceptional economic development opportunity. Available through the direct selling channel of distribution, Rodan + Fields personally reaches its customers, helping them not only achieve great skin, but also build successful independent businesses.
"As the fastest growing segment of the U.S. population, the Hispanic Market represents a great deal of potential growth for the brand," stated Lori Bush, President and General Manager of Rodan + Fields. "We are extremely excited about this outreach campaign and have developed a broad range of programs to attract and engage the Hispanic community."
"We are very optimistic that the business opportunity presented by Rodan + Fields will have a positive economic impact on the Hispanic community due to the family business culture," said Christian Diaz, Vice President of Sales at Rodan + Fields. "It offers people the possibility to establish their own business regardless of language or education. And, in this economy, when many people are looking for ways to generate additional income, it provides a means to create a family business based in the home."
To launch this outreach, Rodan + Fields has signed on as spokesperson and ambassador for the U.S. Hispanic market, Aliza Lifshitz, M.D., better known to the Latino community as la Doctora Aliza. Named as one of the 100 Most Influential Hispanics by Hispanic Business Magazine, Dra. Aliza is one of the most well-known and respected physicians in the Hispanic community. Through this partnership, the brand will extend its mission of empowering people by bringing not only dermatologic skincare, but a business opportunity to everyone.
Dra. Aliza will join Dr. Rodan and Dr. Fields on August 15 as the keynote speaker at the Rodan + Fields National Hispanic Market Launch at the Sheraton Gateway Suites in Chicago. This will be the first time that a Rodan + Fields business presentation will be held in Spanish.
Earlier this year Dr. Rodan and Dr. Fields teamed up with Dra. Aliza to provide the skincare and beauty content for her new Spanish-language health and wellness website, VidaySalud.com. The section, which is entitled Salud y Belleza, includes original skincare articles straight from Dr. Rodan and Dr. Fields. The goal is to help provide readers, many of whom never have the opportunity to visit a dermatologist, with sound clinical advice so they can maintain healthy, beautiful skin. Similar in scope to WebMD, VidaySalud.com is the largest permanent source of health and wellness information in Spanish on the Web.
As part of its Hispanic outreach campaign, Rodan + Fields has assembled a business team comprised of several senior executives with extensive experience and expertise in the international and domestic Hispanic Market, along with the internal infrastructure to fully support its Spanish language initiatives. This includes a full Spanish language version of its website at www.rodanandfields.com.
PRESS RELEASE
SAN FRANCISCO, Aug. 14 /PRNewswire/ -- Rodan + Fields Dermatologists, the clinical skincare brand developed by Stanford University-trained dermatologists Katie Rodan, M.D. and Kathy Fields, M.D., announce the brand's official entrance into the Hispanic market. Through a variety of Spanish language initiatives, Rodan + Fields will bring the dermatologic knowledge and skincare expertise of Dr. Rodan and Dr. Fields to the Hispanic community, offering an exceptional economic development opportunity. Available through the direct selling channel of distribution, Rodan + Fields personally reaches its customers, helping them not only achieve great skin, but also build successful independent businesses.
"As the fastest growing segment of the U.S. population, the Hispanic Market represents a great deal of potential growth for the brand," stated Lori Bush, President and General Manager of Rodan + Fields. "We are extremely excited about this outreach campaign and have developed a broad range of programs to attract and engage the Hispanic community."
"We are very optimistic that the business opportunity presented by Rodan + Fields will have a positive economic impact on the Hispanic community due to the family business culture," said Christian Diaz, Vice President of Sales at Rodan + Fields. "It offers people the possibility to establish their own business regardless of language or education. And, in this economy, when many people are looking for ways to generate additional income, it provides a means to create a family business based in the home."
To launch this outreach, Rodan + Fields has signed on as spokesperson and ambassador for the U.S. Hispanic market, Aliza Lifshitz, M.D., better known to the Latino community as la Doctora Aliza. Named as one of the 100 Most Influential Hispanics by Hispanic Business Magazine, Dra. Aliza is one of the most well-known and respected physicians in the Hispanic community. Through this partnership, the brand will extend its mission of empowering people by bringing not only dermatologic skincare, but a business opportunity to everyone.
Dra. Aliza will join Dr. Rodan and Dr. Fields on August 15 as the keynote speaker at the Rodan + Fields National Hispanic Market Launch at the Sheraton Gateway Suites in Chicago. This will be the first time that a Rodan + Fields business presentation will be held in Spanish.
Earlier this year Dr. Rodan and Dr. Fields teamed up with Dra. Aliza to provide the skincare and beauty content for her new Spanish-language health and wellness website, VidaySalud.com. The section, which is entitled Salud y Belleza, includes original skincare articles straight from Dr. Rodan and Dr. Fields. The goal is to help provide readers, many of whom never have the opportunity to visit a dermatologist, with sound clinical advice so they can maintain healthy, beautiful skin. Similar in scope to WebMD, VidaySalud.com is the largest permanent source of health and wellness information in Spanish on the Web.
As part of its Hispanic outreach campaign, Rodan + Fields has assembled a business team comprised of several senior executives with extensive experience and expertise in the international and domestic Hispanic Market, along with the internal infrastructure to fully support its Spanish language initiatives. This includes a full Spanish language version of its website at www.rodanandfields.com.
Friday, August 14, 2009
Latinos debate healthcare reform
Behind The Healthcare Reform Act
The Latino Journal E-News, August 10, 2009
U.S. House of Representatives Speaker Nancy Pelosi has made a commitment to get healthcare reform legislation through Congress by the end of September. The push by Pelosi and the White House is reminiscent of Barack Obama's grassroots campaign for the Presidency. However the political push is being met by resistance from different factions of Americans who are concerned about the language and cost of the legislation. The resistance has been so strong it has shut down "town hall" meetings and forced Pelosi to call protestors "un-American."
The 1017-page legislation, known as America's Affordable Health Choices Act is difficult to summarize because of its size and the number of strategic components within each provision that are essential to accomplish the overall goal of providing healthcare to more Americans than ever before. As a goal, the Act will provide affordable health care for all Americans and control health care cost growth. The following are the key provisions of the Act, but "the devil is in the details" and a more thorough analysis of the components within each provision will be provided in coming issues of The Latino Journal E-News:
Provisions of the Healthcare Act:
1. Coverage and Choice
The Act will protect current coverage and allow individuals to keep the insurance they have if they like it - and preserves choice of doctors, hospitals, and health plans. It achieves through several components including: A health insurance exchange; a public health insurance option; and, Guaranteed coverage and market reforms.
2. Affordability
Provides sliding scale affordability credits based on individual and family income levels that decline to phase out levels based on achieving 400 percent of federal poverty level ($43,000 for an individual or $88,000 for a family of four). It will cap annual out-of-pocket spending, create competition among healthcare insurance providers, expands Medicaid, and improves Medicare.
3. Shared Responsibility
The bill creates shared responsibility among individuals, employers and government to ensure that all Americans have affordable coverage of essential health benefits. This is accomplished through individual responsibility; employer responsibility; assistance to small employers; and, government responsibility.
4. Prevention and Wellness
This includes: Expansion of Community Health Centers; Prohibition of cost-sharing for preventative services; Creation of community based programs to deliver prevention and wellness services; A focus on community based program and new data collection to better identify and address racial, ethnic, regional and other health disparities; and, Funds to strengthen state, local, tribal and territorial public health departments and programs.
5. Workforce Investments
It will expand health care workforce through: Increased funding for the National Health Service Corp; More training of primary care doctors and an expansion of the pipeline of individuals going into health professions, including primary care, nursing and public health; Greater support for workforce diversity; and, Expansion of scholarships and loans for individuals in needed professions and shortage areas.
6. Controlling Costs
The bill will reduce the growth in health care spending in a numerous ways that include: Modernization and improvement of Medicare; Innovation and delivery reform through the public health insurance option; Improving payment accuracy and eliminating overpayments; Preventing waste, fraud and abuse; and, Administrative simplification.
The Latino Journal E-News will be providing pro and con comments from a Latino perspective regarding the components within the provisions of the Act in coming weeks. If you want to chime in, please write to us and let us know your position on this hot topic. You can email your comments to: latinojournal@gmail.com.
The Latino Journal E-News, August 10, 2009
U.S. House of Representatives Speaker Nancy Pelosi has made a commitment to get healthcare reform legislation through Congress by the end of September. The push by Pelosi and the White House is reminiscent of Barack Obama's grassroots campaign for the Presidency. However the political push is being met by resistance from different factions of Americans who are concerned about the language and cost of the legislation. The resistance has been so strong it has shut down "town hall" meetings and forced Pelosi to call protestors "un-American."
The 1017-page legislation, known as America's Affordable Health Choices Act is difficult to summarize because of its size and the number of strategic components within each provision that are essential to accomplish the overall goal of providing healthcare to more Americans than ever before. As a goal, the Act will provide affordable health care for all Americans and control health care cost growth. The following are the key provisions of the Act, but "the devil is in the details" and a more thorough analysis of the components within each provision will be provided in coming issues of The Latino Journal E-News:
Provisions of the Healthcare Act:
1. Coverage and Choice
The Act will protect current coverage and allow individuals to keep the insurance they have if they like it - and preserves choice of doctors, hospitals, and health plans. It achieves through several components including: A health insurance exchange; a public health insurance option; and, Guaranteed coverage and market reforms.
2. Affordability
Provides sliding scale affordability credits based on individual and family income levels that decline to phase out levels based on achieving 400 percent of federal poverty level ($43,000 for an individual or $88,000 for a family of four). It will cap annual out-of-pocket spending, create competition among healthcare insurance providers, expands Medicaid, and improves Medicare.
3. Shared Responsibility
The bill creates shared responsibility among individuals, employers and government to ensure that all Americans have affordable coverage of essential health benefits. This is accomplished through individual responsibility; employer responsibility; assistance to small employers; and, government responsibility.
4. Prevention and Wellness
This includes: Expansion of Community Health Centers; Prohibition of cost-sharing for preventative services; Creation of community based programs to deliver prevention and wellness services; A focus on community based program and new data collection to better identify and address racial, ethnic, regional and other health disparities; and, Funds to strengthen state, local, tribal and territorial public health departments and programs.
5. Workforce Investments
It will expand health care workforce through: Increased funding for the National Health Service Corp; More training of primary care doctors and an expansion of the pipeline of individuals going into health professions, including primary care, nursing and public health; Greater support for workforce diversity; and, Expansion of scholarships and loans for individuals in needed professions and shortage areas.
6. Controlling Costs
The bill will reduce the growth in health care spending in a numerous ways that include: Modernization and improvement of Medicare; Innovation and delivery reform through the public health insurance option; Improving payment accuracy and eliminating overpayments; Preventing waste, fraud and abuse; and, Administrative simplification.
The Latino Journal E-News will be providing pro and con comments from a Latino perspective regarding the components within the provisions of the Act in coming weeks. If you want to chime in, please write to us and let us know your position on this hot topic. You can email your comments to: latinojournal@gmail.com.
Latino children and obesity
Obesity Is Biggest Health Problem for Kids
Drug Abuse, Bullying, Internet Safety, and Stress Also Make Top 10 List
By Caroline Wilbert, WebMD Health News, Reviewed by Louise Chang, MD
Aug. 13, 2009 -- U.S. adults continue to rate obesity as the biggest health problem for children, according to a 2009 poll conducted by C.S. Mott Children's Hospital.
Although childhood obesity ranked No. 1 last year also, this is the first year it ranked at the top for whites, Hispanics, and African-Americans. Last year, Hispanics rated smoking as the top child health concern and African-Americans ranked teenage pregnancy.
Stress, which came in at No. 8, made the top 10 list for the first time this year. It ranked especially high among lower-income participants, perhaps reflecting the stresses that children face as their parents struggle in the current economy.
The complete list of children's health concerns rated as a "big problem:"
1. Childhood obesity
2. Drug abuse
3. Smoking/tobacco use
4. Bullying
5. Internet safety
6. Child abuse and neglect
7. Alcohol abuse
8. Stress
9. Not enough opportunities for physical activity
10. Teen pregnancy
The fact that stress -- and many other problems on the list -- are behavioral or psychological in nature means that families need more than just good health care; they also need “guidance from community health and educational programs that cultivate healthy, protective behaviors and offer support when health problems
arise,” poll director Matthew Davis, MD, says in a written statement. Davis is an associate professor of general pediatrics and internal medicine at the University of Michigan Medical School and an associate professor of public policy at the University of Michigan Gerald R. Ford School of Public Policy.
The nationally representative survey was conducted in May 2009 and included 2,017 randomly selected adults 18 or older. Participants were asked to rank 23 different health concerns facing children in their communities. The margin of error is plus or minus three to four percentage points.
Drug Abuse, Bullying, Internet Safety, and Stress Also Make Top 10 List
By Caroline Wilbert, WebMD Health News, Reviewed by Louise Chang, MD
Aug. 13, 2009 -- U.S. adults continue to rate obesity as the biggest health problem for children, according to a 2009 poll conducted by C.S. Mott Children's Hospital.
Although childhood obesity ranked No. 1 last year also, this is the first year it ranked at the top for whites, Hispanics, and African-Americans. Last year, Hispanics rated smoking as the top child health concern and African-Americans ranked teenage pregnancy.
Stress, which came in at No. 8, made the top 10 list for the first time this year. It ranked especially high among lower-income participants, perhaps reflecting the stresses that children face as their parents struggle in the current economy.
The complete list of children's health concerns rated as a "big problem:"
1. Childhood obesity
2. Drug abuse
3. Smoking/tobacco use
4. Bullying
5. Internet safety
6. Child abuse and neglect
7. Alcohol abuse
8. Stress
9. Not enough opportunities for physical activity
10. Teen pregnancy
The fact that stress -- and many other problems on the list -- are behavioral or psychological in nature means that families need more than just good health care; they also need “guidance from community health and educational programs that cultivate healthy, protective behaviors and offer support when health problems
arise,” poll director Matthew Davis, MD, says in a written statement. Davis is an associate professor of general pediatrics and internal medicine at the University of Michigan Medical School and an associate professor of public policy at the University of Michigan Gerald R. Ford School of Public Policy.
The nationally representative survey was conducted in May 2009 and included 2,017 randomly selected adults 18 or older. Participants were asked to rank 23 different health concerns facing children in their communities. The margin of error is plus or minus three to four percentage points.
Mostly Latino children dropped by health program
California board votes to drop healthcare coverage for 60,000 children
As a result of state budget cuts, the Healthy Families program will have to begin terminating coverage for more than 60,000 children on Oct. 1. Nearly 670,000 children could be dropped by June 30.
By Patrick McGreevy and Evan Halper, LA Times, August 14, 2009
Reporting from Sacramento - The announcement by state officials that California has enough cash to stop paying bills with IOUs did little to take the sting out of other budget news Thursday: Tens of thousands of poor children are about to lose their healthcare coverage.
A state board voted Thursday to begin terminating health insurance for more than 60,000 children Oct. 1 as a result of the budget amendments signed into law recently by Gov. Arnold Schwarzenegger.
Those children would be up for an annual review of their coverage next month, but instead they may be dropped from the California Healthy Families program under the action by the state Managed Risk Medical Insurance Board.
The board is scrambling to secure funding from other sources, including money set aside by voters for early childhood education, but so far it has come up short.
If additional funds are not found, board officials said, the program could ultimately drop 669,296 children in the current fiscal year, which ends June 30, 2010. Currently, 921,000 people age 18 and younger are enrolled in Healthy Families.
"There are not sufficient funds for the services we are providing," said board chairman Cliff Allenby. "We will work to do what we can do" to find additional money.
The budget cuts made by Schwarzenegger and the Legislature left the Healthy Families program with a $194-million shortfall.
On Thursday, the First 5 California Commission, which administers tobacco-tax funds that voters directed toward early childhood education, agreed to provide $81.4 million for Healthy Families. That is enough to cover 200,000 children through next June, but not enough to stop the vote to begin removing youngsters from the program.
Several advocates for children urged the board to put off a decision and find other ways to compensate for the budget shortfall.
"Families are extremely confused and frightened about what is going to happen to their kids," said Suzie Shupe, executive director of California Children's Health Initiatives.
Clifford Sarkin, a senior policy associate with the Children's Defense Fund California, called the board's vote "devastating. . . . During these economic times, these families rely on the Healthy Families program more than ever."
Meanwhile, a coalition of advocates for the disabled announced Thursday that it has filed a lawsuit against Schwarzenegger to force the restoration of millions of dollars he cut with line-item vetoes from programs that help the sick and disabled. A similar suit was filed this week by state Senate Leader Darrell Steinberg (D-Sacramento).
Despite the money cut from the current budget, California will need to borrow $10.5 billion this year, according to state Treasurer Bill Lockyer and Controller John Chiang.
The borrowing would allow the state to pay all of its bills between late summer and next spring, a period when state accounts typically run short. The loan would be repaid when the usual flood of tax receipts arrives after April 15.
If approved by a state financial board later this month, the borrowing would allow California to stop issuing IOUS -- and begin paying existing ones -- by Sept. 4. Lockyer said a loan would "rid us of the financial hardship and stigma caused by IOUs."
The state controller's office began issuing the notes July 2, when its projections showed the state would not have enough cash to pay all of its bills.
The warrants went to vendors, local governments, students on financial aid, some welfare recipients and taxpayers who were due refunds. The state has issued 327,000 IOUs totaling $1.95 billion.
Officials had planned to wait until October to begin redeeming IOUs, but better cash projections than expected will allow that to start sooner.
Chiang said Thursday that the issuance of IOUS, for only the second time since the Great Depression, has been a "difficult, and frankly, shameful chapter in the state's history."
patrick.mcgreevy@latimes.com
evan.halper@latimes.com
As a result of state budget cuts, the Healthy Families program will have to begin terminating coverage for more than 60,000 children on Oct. 1. Nearly 670,000 children could be dropped by June 30.
By Patrick McGreevy and Evan Halper, LA Times, August 14, 2009
Reporting from Sacramento - The announcement by state officials that California has enough cash to stop paying bills with IOUs did little to take the sting out of other budget news Thursday: Tens of thousands of poor children are about to lose their healthcare coverage.
A state board voted Thursday to begin terminating health insurance for more than 60,000 children Oct. 1 as a result of the budget amendments signed into law recently by Gov. Arnold Schwarzenegger.
Those children would be up for an annual review of their coverage next month, but instead they may be dropped from the California Healthy Families program under the action by the state Managed Risk Medical Insurance Board.
The board is scrambling to secure funding from other sources, including money set aside by voters for early childhood education, but so far it has come up short.
If additional funds are not found, board officials said, the program could ultimately drop 669,296 children in the current fiscal year, which ends June 30, 2010. Currently, 921,000 people age 18 and younger are enrolled in Healthy Families.
"There are not sufficient funds for the services we are providing," said board chairman Cliff Allenby. "We will work to do what we can do" to find additional money.
The budget cuts made by Schwarzenegger and the Legislature left the Healthy Families program with a $194-million shortfall.
On Thursday, the First 5 California Commission, which administers tobacco-tax funds that voters directed toward early childhood education, agreed to provide $81.4 million for Healthy Families. That is enough to cover 200,000 children through next June, but not enough to stop the vote to begin removing youngsters from the program.
Several advocates for children urged the board to put off a decision and find other ways to compensate for the budget shortfall.
"Families are extremely confused and frightened about what is going to happen to their kids," said Suzie Shupe, executive director of California Children's Health Initiatives.
Clifford Sarkin, a senior policy associate with the Children's Defense Fund California, called the board's vote "devastating. . . . During these economic times, these families rely on the Healthy Families program more than ever."
Meanwhile, a coalition of advocates for the disabled announced Thursday that it has filed a lawsuit against Schwarzenegger to force the restoration of millions of dollars he cut with line-item vetoes from programs that help the sick and disabled. A similar suit was filed this week by state Senate Leader Darrell Steinberg (D-Sacramento).
Despite the money cut from the current budget, California will need to borrow $10.5 billion this year, according to state Treasurer Bill Lockyer and Controller John Chiang.
The borrowing would allow the state to pay all of its bills between late summer and next spring, a period when state accounts typically run short. The loan would be repaid when the usual flood of tax receipts arrives after April 15.
If approved by a state financial board later this month, the borrowing would allow California to stop issuing IOUS -- and begin paying existing ones -- by Sept. 4. Lockyer said a loan would "rid us of the financial hardship and stigma caused by IOUs."
The state controller's office began issuing the notes July 2, when its projections showed the state would not have enough cash to pay all of its bills.
The warrants went to vendors, local governments, students on financial aid, some welfare recipients and taxpayers who were due refunds. The state has issued 327,000 IOUs totaling $1.95 billion.
Officials had planned to wait until October to begin redeeming IOUs, but better cash projections than expected will allow that to start sooner.
Chiang said Thursday that the issuance of IOUS, for only the second time since the Great Depression, has been a "difficult, and frankly, shameful chapter in the state's history."
patrick.mcgreevy@latimes.com
evan.halper@latimes.com
Thursday, August 13, 2009
Latino diabetes education initiatives
Local initiatives educate Latinos about diabetes
Margarita Persico, Bay State Banner
Juan Humberto Perez has been a chef for nearly 20 years. He learned the culinary arts from Danny Wisel, a famed Boston executive chef and graduate of France’s prestigious Le Cordon Bleu. Since 1999, Perez has plied his trade as a chef for the Boston Red Sox.
But until recently, oddly enough, he had no idea how to cook for himself.
It was no mystery. A diabetic since 2002, he had little idea of how to treat his disease on a daily basis.
“What can I eat?” was his common inquiry, said Perez, 59, a slim, 5-foot-9-inch, cinnamon-skinned Latino.
If cooking and eating properly is difficult for a professional chef like Perez, imagine what the nearly 400,000 people in Massachusetts with type 2 diabetes must go through.
Type 2 diabetes is a condition in which the body either does not produce enough of the hormone insulin, which is needed to convert sugar into energy, or cannot properly use the insulin that it does produce.
To try to help the many Massachusetts residents living with this disease, several health institutions are launching new programs aimed at boosting diabetic patients’ health by teaching them how to take care of themselves. Part of that includes incorporating better health habits, such as cooking, exercising and managing their weight, into their daily lives.
“Preventing diabetes from getting worse is beyond taking the proper medication,” said Dr. Enrique Caballero, director of the Latino Diabetes Initiative at the Joslin Diabetes Center, who is Perez’s physician. “People with diabetes must incorporate a healthy lifestyle as part of their daily routine.”
“[Treating diabetes] really takes a lot of time and effort and motivation,” added Dr. Alexander Green, associate director of the Disparities Solutions Center at Massachusetts General Hospital (MGH) in Boston. “A coaching program along with nurse education can be an effective approach.”
In nearby Chelsea, MGH’s Chelsea HealthCare Center has incorporated a culturally appropriate and “multidiscipline team approach” to dealing with diabetes.
The center’s staff reaches out to the local Latino at-risk population, according to Barbara B. Chase, nurse practitioner and coordinator of the center’s Diabetes Management Program. They provide health care coaching, mental health services and diabetes self-management education (DSME) programs, as well as ongoing support groups offered in both English and Spanish.
Perez, also an artist who paints about the Red Sox, said he had never been offered formal diabetes education classes. When he found out the Joslin Diabetes Center’s Latino Diabetic Initiative had such an education program, he switched doctors to take advantage.
He recalls how out of control his blood sugar had been. The ideal blood sugar level is under 100 milligrams of glucose per deciliter of blood. One day, his was nearly 300 milligrams per deciliter. He decided to take 10 additional units of insulin, even though he knew he was taking a risk.
“My sugar never goes up that high,” said Perez.
Later, at the diabetes management classes, Perez learned that injectable insulin expires 30 days after opening.
Both MGH and Joslin’s Latino Diabetes Initiative are trying to get this kind of information to local Latino communities. Joslin has developed a series of culturally tailored programs with educational tools such as the DSME classes, exercise groups, grocery shopping tours and even an audio soap opera.
It is important to take into consideration health literacy levels, or the ability people have to comprehend health care messages, according to Caballero. He says health messages and materials need to be appropriate for each patient’s literacy level.
The Joslin Latino Diabetes Initiative has several culturally oriented strategies to educate their population. One of them is “La Historia de Rosa (Rosa’s Story),” an audio novella CD, recorded in Spanish and designed for patients with low health literacy. This tool educates not only the patients, but also their families about diabetes’ basic care and prevention, said Caballero.
“[‘Rosa’s Story’] conveys the message on what they need to do in terms of their diabetes, their nutrition, their exercise, their medications, glucose testing [and] diabetes prevention in a very practical, interesting, funny way,” said Caballero.
But the Joslin initiative, which started in 2002, recognizes patients’ need for more educational resources.
“One example of our culturally oriented activities is that we just created a pilot [program] of salsa dancing,” said Caballero. “Many of our patients said they … didn’t like to run or jog, but that they would dance.”
That led Caballero and his team to hire a salsa instructor for a monthly meeting with his patients at Boylston Congregational Church in Jamaica Plain.
“We all get together with the patients, and we dance for a little bit,” said Caballero. “And we take that opportunity to also convey some educational messages of what to do with their diabetes, how to improve their care.”
The approach has earned praise within the field. Caballero and his team were the recipients of the National Minority Quality Forum’s 2009 Bernardo Alberto Houssay award for their work with minority and underserved populations.
Another strategy that Joslin educators have used is conducting supermarket tours to educate their low-income patients on how to purchase healthy food within their budget.
“Sometimes healthier foods are more expensive, but not all the time,” said Caballero. “So even within a limited budget, people can make better choices. And so now we go exactly to where people buy the food and teach people how to do that in a better way.”
After patients learn how to purchase healthy food on a budget, they need to know how much to consume. The Joslin initiative has that class, too — “Balanceando su plato; como planificar sus comidas,” or “Balancing your plate; How to plan your meals.” In that class, patients learn about carbohydrates and meal planning.
Depending on the patient’s health literacy level, Andreina Millan-Ferro — the patient education and clinical outcomes coordinator at the Joslin Latino Diabetes Initiative — may recommend trying carbohydrate counting or what is called “the plate method.”
“They divide the plate into three different sections,” said Millan-Ferro, a trained nutritionist. “… Half of the plate [is] for vegetables, and then the other half they divide by half. They will put the carbohydrates in one quarter of the plate, and the meat in one quarter of the plate.”
Patients are allowed two other portions, she said — a portion of fruit and a glass of milk, for instance.
All of these programs need funding, said Caballero. But they often go without, he added, because insurance companies do not always consider the educational and health values of culturally oriented programs.
Perez said he thinks that should change because, since he started attending classes at the Joslin clinic, he has felt better. He said he thinks insurance companies would save a lot of money by promoting measures to control more serious complications from a disease.
“I now keep track of my blood sugar levels before and after meals, and I make sure that I eat the proper nutrition and the right portions of food,” said Perez, who now exercises regularly.
And it seems to be working — Perez said he hasn’t needed insulin since May 7.
“Now I’m in control of everything I eat,” said Perez. “So it’s easy for me to maintain my blood sugar at a good and healthy level.”
Margarita Persico, Bay State Banner
Juan Humberto Perez has been a chef for nearly 20 years. He learned the culinary arts from Danny Wisel, a famed Boston executive chef and graduate of France’s prestigious Le Cordon Bleu. Since 1999, Perez has plied his trade as a chef for the Boston Red Sox.
But until recently, oddly enough, he had no idea how to cook for himself.
It was no mystery. A diabetic since 2002, he had little idea of how to treat his disease on a daily basis.
“What can I eat?” was his common inquiry, said Perez, 59, a slim, 5-foot-9-inch, cinnamon-skinned Latino.
If cooking and eating properly is difficult for a professional chef like Perez, imagine what the nearly 400,000 people in Massachusetts with type 2 diabetes must go through.
Type 2 diabetes is a condition in which the body either does not produce enough of the hormone insulin, which is needed to convert sugar into energy, or cannot properly use the insulin that it does produce.
To try to help the many Massachusetts residents living with this disease, several health institutions are launching new programs aimed at boosting diabetic patients’ health by teaching them how to take care of themselves. Part of that includes incorporating better health habits, such as cooking, exercising and managing their weight, into their daily lives.
“Preventing diabetes from getting worse is beyond taking the proper medication,” said Dr. Enrique Caballero, director of the Latino Diabetes Initiative at the Joslin Diabetes Center, who is Perez’s physician. “People with diabetes must incorporate a healthy lifestyle as part of their daily routine.”
“[Treating diabetes] really takes a lot of time and effort and motivation,” added Dr. Alexander Green, associate director of the Disparities Solutions Center at Massachusetts General Hospital (MGH) in Boston. “A coaching program along with nurse education can be an effective approach.”
In nearby Chelsea, MGH’s Chelsea HealthCare Center has incorporated a culturally appropriate and “multidiscipline team approach” to dealing with diabetes.
The center’s staff reaches out to the local Latino at-risk population, according to Barbara B. Chase, nurse practitioner and coordinator of the center’s Diabetes Management Program. They provide health care coaching, mental health services and diabetes self-management education (DSME) programs, as well as ongoing support groups offered in both English and Spanish.
Perez, also an artist who paints about the Red Sox, said he had never been offered formal diabetes education classes. When he found out the Joslin Diabetes Center’s Latino Diabetic Initiative had such an education program, he switched doctors to take advantage.
He recalls how out of control his blood sugar had been. The ideal blood sugar level is under 100 milligrams of glucose per deciliter of blood. One day, his was nearly 300 milligrams per deciliter. He decided to take 10 additional units of insulin, even though he knew he was taking a risk.
“My sugar never goes up that high,” said Perez.
Later, at the diabetes management classes, Perez learned that injectable insulin expires 30 days after opening.
Both MGH and Joslin’s Latino Diabetes Initiative are trying to get this kind of information to local Latino communities. Joslin has developed a series of culturally tailored programs with educational tools such as the DSME classes, exercise groups, grocery shopping tours and even an audio soap opera.
It is important to take into consideration health literacy levels, or the ability people have to comprehend health care messages, according to Caballero. He says health messages and materials need to be appropriate for each patient’s literacy level.
The Joslin Latino Diabetes Initiative has several culturally oriented strategies to educate their population. One of them is “La Historia de Rosa (Rosa’s Story),” an audio novella CD, recorded in Spanish and designed for patients with low health literacy. This tool educates not only the patients, but also their families about diabetes’ basic care and prevention, said Caballero.
“[‘Rosa’s Story’] conveys the message on what they need to do in terms of their diabetes, their nutrition, their exercise, their medications, glucose testing [and] diabetes prevention in a very practical, interesting, funny way,” said Caballero.
But the Joslin initiative, which started in 2002, recognizes patients’ need for more educational resources.
“One example of our culturally oriented activities is that we just created a pilot [program] of salsa dancing,” said Caballero. “Many of our patients said they … didn’t like to run or jog, but that they would dance.”
That led Caballero and his team to hire a salsa instructor for a monthly meeting with his patients at Boylston Congregational Church in Jamaica Plain.
“We all get together with the patients, and we dance for a little bit,” said Caballero. “And we take that opportunity to also convey some educational messages of what to do with their diabetes, how to improve their care.”
The approach has earned praise within the field. Caballero and his team were the recipients of the National Minority Quality Forum’s 2009 Bernardo Alberto Houssay award for their work with minority and underserved populations.
Another strategy that Joslin educators have used is conducting supermarket tours to educate their low-income patients on how to purchase healthy food within their budget.
“Sometimes healthier foods are more expensive, but not all the time,” said Caballero. “So even within a limited budget, people can make better choices. And so now we go exactly to where people buy the food and teach people how to do that in a better way.”
After patients learn how to purchase healthy food on a budget, they need to know how much to consume. The Joslin initiative has that class, too — “Balanceando su plato; como planificar sus comidas,” or “Balancing your plate; How to plan your meals.” In that class, patients learn about carbohydrates and meal planning.
Depending on the patient’s health literacy level, Andreina Millan-Ferro — the patient education and clinical outcomes coordinator at the Joslin Latino Diabetes Initiative — may recommend trying carbohydrate counting or what is called “the plate method.”
“They divide the plate into three different sections,” said Millan-Ferro, a trained nutritionist. “… Half of the plate [is] for vegetables, and then the other half they divide by half. They will put the carbohydrates in one quarter of the plate, and the meat in one quarter of the plate.”
Patients are allowed two other portions, she said — a portion of fruit and a glass of milk, for instance.
All of these programs need funding, said Caballero. But they often go without, he added, because insurance companies do not always consider the educational and health values of culturally oriented programs.
Perez said he thinks that should change because, since he started attending classes at the Joslin clinic, he has felt better. He said he thinks insurance companies would save a lot of money by promoting measures to control more serious complications from a disease.
“I now keep track of my blood sugar levels before and after meals, and I make sure that I eat the proper nutrition and the right portions of food,” said Perez, who now exercises regularly.
And it seems to be working — Perez said he hasn’t needed insulin since May 7.
“Now I’m in control of everything I eat,” said Perez. “So it’s easy for me to maintain my blood sugar at a good and healthy level.”
Hispanic immigrants left out of healthcare
Latinos Wait For Health Care Reform While Illegal Immigrants Face Care Decisions
Kaiser Health News, Aug 11, 2009
The health care needs of an estimated 6.8 million undocumented and uninsured immigrants "has become the third rail in the debate over health-care reform," The Chicago Tribune reports. Some health care advocates have proposed broadening the proposals before Congress to include this population, but "fierce opposition has kept the idea off the table."
House Speaker Nancy Pelosi has "emphasized that illegal immigrants would not be covered under the current proposals." And the Congressional Hispanic Caucus has called for coverage "only for 'legal, law-abiding' immigrants who pay their 'fair share' for health care."
But "immigration activists say it is 'immoral' for hospitals and doctors, as well as a nation, to deny health care to the seriously ill, no matter their legal status. But proponents of tougher Immigration enforcement -- and others fighting to contain runaway health-care costs -- fear that providing such services would only encourage more undocumented immigrants to cross the border" (Olivo, 8/11).
The Associated Press reports Latinos are the least likely among the major ethnic groups to have health insurance through work and are watching closely the reform legislation in Congress. "Experts say health disparities among ethnic groups are great, with one in three Hispanics and one in five African-Americans not having health insurance, compared with one in eight whites. And as the recession deepens, the gap is growing along with rising unemployment and cuts to work-sponsored insurance."
Meanwhile, the AP also notes that although the House bill "represents the most comprehensive effort to date to extend health care to all Americans," illegal immigrants would be excluded. And "absent immigration reform and a path to citizenship, that would mean millions could be left out of the system. About 59 percent of the 11.9 million undocumented immigrants living in the United States have no health insurance, according to the Pew Hispanic Center" (Barbassa, 8/10).
Kaiser Health News, Aug 11, 2009
The health care needs of an estimated 6.8 million undocumented and uninsured immigrants "has become the third rail in the debate over health-care reform," The Chicago Tribune reports. Some health care advocates have proposed broadening the proposals before Congress to include this population, but "fierce opposition has kept the idea off the table."
House Speaker Nancy Pelosi has "emphasized that illegal immigrants would not be covered under the current proposals." And the Congressional Hispanic Caucus has called for coverage "only for 'legal, law-abiding' immigrants who pay their 'fair share' for health care."
But "immigration activists say it is 'immoral' for hospitals and doctors, as well as a nation, to deny health care to the seriously ill, no matter their legal status. But proponents of tougher Immigration enforcement -- and others fighting to contain runaway health-care costs -- fear that providing such services would only encourage more undocumented immigrants to cross the border" (Olivo, 8/11).
The Associated Press reports Latinos are the least likely among the major ethnic groups to have health insurance through work and are watching closely the reform legislation in Congress. "Experts say health disparities among ethnic groups are great, with one in three Hispanics and one in five African-Americans not having health insurance, compared with one in eight whites. And as the recession deepens, the gap is growing along with rising unemployment and cuts to work-sponsored insurance."
Meanwhile, the AP also notes that although the House bill "represents the most comprehensive effort to date to extend health care to all Americans," illegal immigrants would be excluded. And "absent immigration reform and a path to citizenship, that would mean millions could be left out of the system. About 59 percent of the 11.9 million undocumented immigrants living in the United States have no health insurance, according to the Pew Hispanic Center" (Barbassa, 8/10).
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