Outreach planned for Hispanic diabetics
By Keila Torres Staff writer 01/30/2009
BRIDGEPORT -- Bridgeport Hospital plans to offer in-home diabetes education services for Spanish-speaking adults.
Hispanics, like blacks and American Indians, have a high genetic disposition for diabetes, according to medical authorities. For Latinos, though, the language barrier can be a detriment to acquiring vital information needed to treat their condition, as well as to provide advice on exercise routines, nutrition and general health care, said Dr. Stuart Zarich, the hospital's chief of cardiology.
Treating the disease is "really something you have to do day to day," Zarich said. "Diabetes is really all about self-empowerment and learning to take care of yourself. If you don't understand diabetes, it's almost impossible to treat."
Without close monitoring and treatment, diabetes can lead to heart disease, blindness, kidney disease and other problems, he added.
Through the program, Hispanic patients will receive information about how to understand their condition, including how to monitor their blood-sugar levels. The program will be tailored to address "ethnic or cultural reasons why they may not want to take a medicine," Zarich said.
People will be referred to the new program by local clinics and physicians at the hospital. "Typically, we are looking for uninsured, Spanish-speaking patients with diabetes," he said.
According to Steve Jakab, president of the Bridgeport Hospital Foundation, the hospital has a large number of Latino patients. "We certainly see enough people currently that we can make the referrals ourselves," he said.
The program will be funded through a $50,000 grant given by Anthem Blue Cross/Blue Shield of Connecticut. The grant, which is good for one year, will pay for the salary of a yet-to-be-hired certified diabetes educator and for diabetes pamphlets and materials printed in Spanish.
"We're very pleased to be able to partner with Bridgeport Hospital to help uninsured folks who suffer from diabetes in the greater Bridgeport area," said Jim Augur, vice president of sales for Anthem.
For the at-home sessions, patients will receive the same services now offered by the hospital's outpatient diabetes education program.
Saturday, January 31, 2009
Wednesday, January 28, 2009
American Latinos do not respond to psychotropic medication
Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review
By Nicole M. Lanouette, M.D., David P. Folsom, M.D., M.P.H., Andres Sciolla, M.D. and Dilip V. Jeste, M.D.
The authors are affiliated with the Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., 9116A-13, La Jolla, CA 92093 (e-mail: nlanouette@ucsd.edu). Dr. Jeste is also with the Psychiatry Service, Veterans Affairs San Diego Healthcare System. The findings of this study were presented in a poster session at the Critical Research Issues in Latino Mental Health Conference, Santa Fe, New Mexico, March 10–12, 2008.
OBJECTIVE: Psychotropic medication nonadherence is a major public health problem, but few studies have focused on Latinos. The authors systematically reviewed the literature on rates of and factors influencing antipsychotic, antidepressant, and mood stabilizer nonadherence among U.S. Latinos.
METHODS: MEDLINE and PsycINFO were searched by using the keywords adherence, compliance, Latino, Hispanic, psychotropic, and related terms; bibliographies from relevant reviews and studies were also searched. Twenty-one studies met inclusion criteria: published since 1980 in English or Spanish and measured psychotropic medication nonadherence rates among U.S. Latino adults. Information was extracted about study design and objective, location, population, medication type, participant demographic characteristics, adherence measures, adherence rates, and factors related to adherence.
RESULTS: In the 17 studies that included Latinos and other minority groups, mean nonadherence rates were 41%, 31%, and 43%, respectively, among Latinos, Euro-Americans, and African Americans, with an overall effect size of .64 between Latinos and Euro-Americans. In the four studies that included only Latinos, the mean nonadherence rate was 44%. Ten of 16 studies found that Latinos had significantly lower adherence rates than Euro-Americans.
Risk factors for nonadherence included being a monolingual Spanish speaker, lacking health insurance, experiencing access barriers to high-quality care, and having lower socioeconomic status. Protective factors included family support and psychotherapy.
CONCLUSIONS: Rates of nonadherence to psychotropic medications were found to be higher for Latinos than for Euro-Americans. Further investigation is needed to understand the potentially modifiable individual and society-level mechanisms of this discrepancy. Clinical and research interventions to improve adherence should be culturally appropriate and incorporate identified factors.
By Nicole M. Lanouette, M.D., David P. Folsom, M.D., M.P.H., Andres Sciolla, M.D. and Dilip V. Jeste, M.D.
The authors are affiliated with the Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., 9116A-13, La Jolla, CA 92093 (e-mail: nlanouette@ucsd.edu). Dr. Jeste is also with the Psychiatry Service, Veterans Affairs San Diego Healthcare System. The findings of this study were presented in a poster session at the Critical Research Issues in Latino Mental Health Conference, Santa Fe, New Mexico, March 10–12, 2008.
OBJECTIVE: Psychotropic medication nonadherence is a major public health problem, but few studies have focused on Latinos. The authors systematically reviewed the literature on rates of and factors influencing antipsychotic, antidepressant, and mood stabilizer nonadherence among U.S. Latinos.
METHODS: MEDLINE and PsycINFO were searched by using the keywords adherence, compliance, Latino, Hispanic, psychotropic, and related terms; bibliographies from relevant reviews and studies were also searched. Twenty-one studies met inclusion criteria: published since 1980 in English or Spanish and measured psychotropic medication nonadherence rates among U.S. Latino adults. Information was extracted about study design and objective, location, population, medication type, participant demographic characteristics, adherence measures, adherence rates, and factors related to adherence.
RESULTS: In the 17 studies that included Latinos and other minority groups, mean nonadherence rates were 41%, 31%, and 43%, respectively, among Latinos, Euro-Americans, and African Americans, with an overall effect size of .64 between Latinos and Euro-Americans. In the four studies that included only Latinos, the mean nonadherence rate was 44%. Ten of 16 studies found that Latinos had significantly lower adherence rates than Euro-Americans.
Risk factors for nonadherence included being a monolingual Spanish speaker, lacking health insurance, experiencing access barriers to high-quality care, and having lower socioeconomic status. Protective factors included family support and psychotherapy.
CONCLUSIONS: Rates of nonadherence to psychotropic medications were found to be higher for Latinos than for Euro-Americans. Further investigation is needed to understand the potentially modifiable individual and society-level mechanisms of this discrepancy. Clinical and research interventions to improve adherence should be culturally appropriate and incorporate identified factors.
Latinos experiencing alarming increas in Alzheimer's
Researchers: Alzheimer's disease skyrocketing among Latinos
By Vicente Arenas / 11 News January 27, 2009
HOUSTON—One day in 1993, Jesus Ulloa noticed something was wrong with his wife, Frances.
She started to repeat things and exhibit other odd behaviors, like ordering checkbooks they didn’t need.
Then came the shocking news: The strong, charismatic, loving mother of his six children had Alzheimer’s.
It didn’t take long for the debilitating brain disease to take its toll.
Her forgetfulness soon got worse, and she lost the ability to walk.
Then her old friends started shying away.
“To me, this is the new leprosy, like the leprosy of the 21st Century. People, as soon as they know somebody has Alzheimer’s, they stay away,” daughter Laura Garrett said.
Doctors said that’s one reason why so many Latinos and Spanish-speakers wait so late to get diagnosed – they consider the disease to be taboo.
Even though friends left, the family came together, and now they work as a team to care for their mother at home.
The Alzheimer’s Association of Houston knows one of its biggest challenges will come from the city’s growing Hispanic population.
“And that’s why we try to educate the community that there are certain neurological changes that occur in the brain, and the earlier they can get a diagnosis, the earlier there can be an intervention,” John Meade of the Alzheimer’s Association of Houston said.
When it comes to Latinos, Alzheimer’s forecasts are startling.
Researchers expect a 600-percent increase in Hispanics suffering from the disease by the year 2050.
They believe the dramatic rise will be partly due to diabetes and lack of medical care.
Others simply won’t be diagnosed early enough.
“So what has happened is that the Hispanic community is now eight times more at risk,” Dr. Adrianna Strutt of Baylor Neuropsychology said.
Strutt is trying to turn those numbers around by studying current Alzheimer’s tests and coming up with new ones designed specifically for Latinos and Spanish-speakers.
“At least with this research, what we are trying to do is get rid of all those extra factors that could be clouding the results,” Strutt said.
Strutt said traditional tests don’t always catch Alzheimer’s early enough in the Latino community.
As for Frances Ulloa, she’s now in the final stages of Alzheimer’s.
Her family agreed to share her story in the hopes that other families will seek help early on.
By Vicente Arenas / 11 News January 27, 2009
HOUSTON—One day in 1993, Jesus Ulloa noticed something was wrong with his wife, Frances.
She started to repeat things and exhibit other odd behaviors, like ordering checkbooks they didn’t need.
Then came the shocking news: The strong, charismatic, loving mother of his six children had Alzheimer’s.
It didn’t take long for the debilitating brain disease to take its toll.
Her forgetfulness soon got worse, and she lost the ability to walk.
Then her old friends started shying away.
“To me, this is the new leprosy, like the leprosy of the 21st Century. People, as soon as they know somebody has Alzheimer’s, they stay away,” daughter Laura Garrett said.
Doctors said that’s one reason why so many Latinos and Spanish-speakers wait so late to get diagnosed – they consider the disease to be taboo.
Even though friends left, the family came together, and now they work as a team to care for their mother at home.
The Alzheimer’s Association of Houston knows one of its biggest challenges will come from the city’s growing Hispanic population.
“And that’s why we try to educate the community that there are certain neurological changes that occur in the brain, and the earlier they can get a diagnosis, the earlier there can be an intervention,” John Meade of the Alzheimer’s Association of Houston said.
When it comes to Latinos, Alzheimer’s forecasts are startling.
Researchers expect a 600-percent increase in Hispanics suffering from the disease by the year 2050.
They believe the dramatic rise will be partly due to diabetes and lack of medical care.
Others simply won’t be diagnosed early enough.
“So what has happened is that the Hispanic community is now eight times more at risk,” Dr. Adrianna Strutt of Baylor Neuropsychology said.
Strutt is trying to turn those numbers around by studying current Alzheimer’s tests and coming up with new ones designed specifically for Latinos and Spanish-speakers.
“At least with this research, what we are trying to do is get rid of all those extra factors that could be clouding the results,” Strutt said.
Strutt said traditional tests don’t always catch Alzheimer’s early enough in the Latino community.
As for Frances Ulloa, she’s now in the final stages of Alzheimer’s.
Her family agreed to share her story in the hopes that other families will seek help early on.
Hispanic kids' mental health affected by weight
Weight affects white, Hispanic kids' mental health
Reuters Jan 27, 2009
NEW YORK (Reuters Health) - A new study adds to evidence that overweight teenagers are more prone to depression and anxiety, but suggests the effects vary by race and ethnicity.
Researchers found that among more than 35,000 U.S. teenagers in a national health survey, white and Hispanic teens who were overweight were more likely to have symptoms of depression or anxiety than their thinner counterparts.
However, this was not true of overweight African-American teenagers, the researchers report in the journal Pediatrics.
The reasons for the racial and ethnic differences are not apparent from the findings, according to Dr. Rhonda BeLue and colleagues at Pennsylvania State University in University Park.
In other studies, they note, suggest that black teenagers are simply not as bothered by excess pounds as white teens are, and seem to be under less pressure from family and friends to be thin.
It's also possible that black teenagers often deal with a "constellation" of stresses in their lives, so that excess weight has little impact on their mental well-being, BeLue and her colleagues note.
The findings are based on a government survey of parents of 35,184 adolescents 12-to-1-year hold. Among white and Hispanic parents, those with an overweight child were more likely to say the teen had depression or anxiety.
In general, African-American teens had higher rates of some of these problems, but weight seemed to have no influence.
The findings, according to BeLue's team, suggest that when doctors address teenagers' weight problems, they should also try to assess their mental health. At the same time, they add, programs aimed at tackling childhood obesity should be aware that different groups of kids may have different risks of mental health problems.
SOURCE: Pediatrics, February 2009.
Reuters Jan 27, 2009
NEW YORK (Reuters Health) - A new study adds to evidence that overweight teenagers are more prone to depression and anxiety, but suggests the effects vary by race and ethnicity.
Researchers found that among more than 35,000 U.S. teenagers in a national health survey, white and Hispanic teens who were overweight were more likely to have symptoms of depression or anxiety than their thinner counterparts.
However, this was not true of overweight African-American teenagers, the researchers report in the journal Pediatrics.
The reasons for the racial and ethnic differences are not apparent from the findings, according to Dr. Rhonda BeLue and colleagues at Pennsylvania State University in University Park.
In other studies, they note, suggest that black teenagers are simply not as bothered by excess pounds as white teens are, and seem to be under less pressure from family and friends to be thin.
It's also possible that black teenagers often deal with a "constellation" of stresses in their lives, so that excess weight has little impact on their mental well-being, BeLue and her colleagues note.
The findings are based on a government survey of parents of 35,184 adolescents 12-to-1-year hold. Among white and Hispanic parents, those with an overweight child were more likely to say the teen had depression or anxiety.
In general, African-American teens had higher rates of some of these problems, but weight seemed to have no influence.
The findings, according to BeLue's team, suggest that when doctors address teenagers' weight problems, they should also try to assess their mental health. At the same time, they add, programs aimed at tackling childhood obesity should be aware that different groups of kids may have different risks of mental health problems.
SOURCE: Pediatrics, February 2009.
Hispanic wellness targeted by ad campaign
got milk? Presents Milk, Nature's Wellness Drink, to Hispanics With a Little Help from Universal Beauty Dayanara Torres
Popular Hispanic campaign revs up the new year with a new celebrity and a new wellness campaign
PRESS RELEASE
MIAMI, Jan. 27 /PRNewswire/ -- Internationally recognized beauty queen, author, actress and humanitarian Dayanara Torres is adding two major accolades to her long list of accomplishments: she's the latest famous face to proudly wear a milk mustache and is the official spokesperson of got milk?'s wellness campaign. As part of the campaign, Dayanara will help "reintroduce" Hispanics to milk as nature's wellness drink.
Looking just as vibrant, fit and healthy as she did 15 years ago when she was introduced to the world as Miss Universe 1993, Dayanara is one of a cadre of more than 250 famous faces who have lent their upper lips in support of milk. Just when Hispanics are actively seeking solutions to achieve wellness -- yet are frequently turning to manufactured, new-age beverages -- Dayanara is helping to remind people that milk is nature's wellness drink, a naturally nutrient-rich choice that offers an array of benefits that these fortified beverages are attempting to duplicate.
Dayanara helped launch the new "Drink Well. Live Well." initiative for the Hispanic got milk? campaign today at a press conference in Miami, unveiling her much anticipated Milk Mustache ad. The wellness initiative for milk includes new national television commercials, a coast-to-coast wellness tour and Dayanara's Milk Mustache ad.
Dayanara's "testimony" to wellness featured in the new ad includes:
"As a professional I do many things, but as a mother insuring my children's wellbeing is the most important. That's why I give them 3 glasses of milk a day. Lowfat and fat free milk have 9 essential nutrients, including vitamin A that helps regulate the immune system. Protecting my family's health is the best thing I can do, which is why I serve them milk."
New Face of Wellness
The new campaign is helping to draw attention to the many wellness benefits of milk and the unique attributes of being a milk drinker. Milk is a nutrient-laden liquid that supplies many of the vitamins and minerals that Hispanics fail to get enough of in their daily diets. Each glass of milk is packed with nine essential nutrients: calcium, vitamin D, protein, phosphorus, riboflavin, vitamin B-12, vitamin A, potassium and niacin. Studies suggest that milk drinkers tend to have healthier diets than people who drink little or no milk.
"It's only logical to think of milk as a wellness drink because it's one of the most nutrient-packed beverages you can buy," said wellness expert and registered nutritionist SuNui Escobar, who helped launch the new campaign today along with Dayanara. "Milk supplies more nutrients for your dollar than any other drink. You can get your wellness by the gallon with milk." SuNui said drinking lowfat or fat free milk each day is one simple step everyone can take toward achieving overall wellness. Plus, what other beverage can say it's been endorsed by more than 250 celebrities?
"I feel privileged to be able to reach out to all the Hispanic moms and talk about the role milk can play in the wellbeing of their families. I understand what is most important to us moms and none is more critical than the wellbeing of our kids," Dayanara said.
Wellness Role Models
Perhaps the most powerful testaments for milk are the milk mustache celebrity moms who have been part of the popular campaign. It's no coincidence that these healthy and fit celebrities bring to life the true meaning of wellness. Lili Estefan and her son Lorenzo helped launch the original campaign, and more recent additions to the roster have included Sofia Vergara, Barbara Mori, Sara Ramirez, Alicia Villarreal and Charytin. These famous milk-drinking role models truly embody the concept of living well.
To help showcase the many advantages of being a milk drinker, a new report entitled "The New Face of Wellness: A Look at America's Milk Drinkers" documents the science-based benefits of drinking milk. Milk drinkers may have a health edge, giving Hispanics more reason to get the recommended three glasses of lowfat or fat free milk each day. Decades of studies show that milk drinkers have stronger, denser bones and are less likely to suffer from osteoporosis.
Other studies suggest that grabbing as little as one glass of lowfat or fat free milk a day could help protect your heart and may even reduce the risk for type 2 diabetes and metabolic syndrome, while emerging evidence suggests the nutrients in milk may play a role in reducing the risk of certain cancers. The new report is available at www.eligeleche.com.
Drink Well. Live Well.
Visit www.eligeleche.com to see how you can achieve wellness in your life and possibly the chance to win one of four exclusive spa retreats at the luxurious Grand Wailea Resort and Spa in Maui! Enjoy elegant accommodations, indulgent spa treatments, fine dining, and thrilling recreation at this world- class resort. Daily prizes will be given away from SpaFinder and Curves. See official rules at www.eligeleche.com for more details.
The Milk Processor Education Program (MilkPEP), Washington, D.C., is funded by the nation's milk processors, who are committed to increasing fluid milk consumption. The MilkPEP Board runs the national Milk Mustache "got milk?"(R) Campaign, a multi-faceted campaign designed to educate consumers about the health benefits of milk. For more information, go to www.whymilk.com. Lowe New York is the creative agency for the national Milk Mustache "got milk?" Campaign.
Popular Hispanic campaign revs up the new year with a new celebrity and a new wellness campaign
PRESS RELEASE
MIAMI, Jan. 27 /PRNewswire/ -- Internationally recognized beauty queen, author, actress and humanitarian Dayanara Torres is adding two major accolades to her long list of accomplishments: she's the latest famous face to proudly wear a milk mustache and is the official spokesperson of got milk?'s wellness campaign. As part of the campaign, Dayanara will help "reintroduce" Hispanics to milk as nature's wellness drink.
Looking just as vibrant, fit and healthy as she did 15 years ago when she was introduced to the world as Miss Universe 1993, Dayanara is one of a cadre of more than 250 famous faces who have lent their upper lips in support of milk. Just when Hispanics are actively seeking solutions to achieve wellness -- yet are frequently turning to manufactured, new-age beverages -- Dayanara is helping to remind people that milk is nature's wellness drink, a naturally nutrient-rich choice that offers an array of benefits that these fortified beverages are attempting to duplicate.
Dayanara helped launch the new "Drink Well. Live Well." initiative for the Hispanic got milk? campaign today at a press conference in Miami, unveiling her much anticipated Milk Mustache ad. The wellness initiative for milk includes new national television commercials, a coast-to-coast wellness tour and Dayanara's Milk Mustache ad.
Dayanara's "testimony" to wellness featured in the new ad includes:
"As a professional I do many things, but as a mother insuring my children's wellbeing is the most important. That's why I give them 3 glasses of milk a day. Lowfat and fat free milk have 9 essential nutrients, including vitamin A that helps regulate the immune system. Protecting my family's health is the best thing I can do, which is why I serve them milk."
New Face of Wellness
The new campaign is helping to draw attention to the many wellness benefits of milk and the unique attributes of being a milk drinker. Milk is a nutrient-laden liquid that supplies many of the vitamins and minerals that Hispanics fail to get enough of in their daily diets. Each glass of milk is packed with nine essential nutrients: calcium, vitamin D, protein, phosphorus, riboflavin, vitamin B-12, vitamin A, potassium and niacin. Studies suggest that milk drinkers tend to have healthier diets than people who drink little or no milk.
"It's only logical to think of milk as a wellness drink because it's one of the most nutrient-packed beverages you can buy," said wellness expert and registered nutritionist SuNui Escobar, who helped launch the new campaign today along with Dayanara. "Milk supplies more nutrients for your dollar than any other drink. You can get your wellness by the gallon with milk." SuNui said drinking lowfat or fat free milk each day is one simple step everyone can take toward achieving overall wellness. Plus, what other beverage can say it's been endorsed by more than 250 celebrities?
"I feel privileged to be able to reach out to all the Hispanic moms and talk about the role milk can play in the wellbeing of their families. I understand what is most important to us moms and none is more critical than the wellbeing of our kids," Dayanara said.
Wellness Role Models
Perhaps the most powerful testaments for milk are the milk mustache celebrity moms who have been part of the popular campaign. It's no coincidence that these healthy and fit celebrities bring to life the true meaning of wellness. Lili Estefan and her son Lorenzo helped launch the original campaign, and more recent additions to the roster have included Sofia Vergara, Barbara Mori, Sara Ramirez, Alicia Villarreal and Charytin. These famous milk-drinking role models truly embody the concept of living well.
To help showcase the many advantages of being a milk drinker, a new report entitled "The New Face of Wellness: A Look at America's Milk Drinkers" documents the science-based benefits of drinking milk. Milk drinkers may have a health edge, giving Hispanics more reason to get the recommended three glasses of lowfat or fat free milk each day. Decades of studies show that milk drinkers have stronger, denser bones and are less likely to suffer from osteoporosis.
Other studies suggest that grabbing as little as one glass of lowfat or fat free milk a day could help protect your heart and may even reduce the risk for type 2 diabetes and metabolic syndrome, while emerging evidence suggests the nutrients in milk may play a role in reducing the risk of certain cancers. The new report is available at www.eligeleche.com.
Drink Well. Live Well.
Visit www.eligeleche.com to see how you can achieve wellness in your life and possibly the chance to win one of four exclusive spa retreats at the luxurious Grand Wailea Resort and Spa in Maui! Enjoy elegant accommodations, indulgent spa treatments, fine dining, and thrilling recreation at this world- class resort. Daily prizes will be given away from SpaFinder and Curves. See official rules at www.eligeleche.com for more details.
The Milk Processor Education Program (MilkPEP), Washington, D.C., is funded by the nation's milk processors, who are committed to increasing fluid milk consumption. The MilkPEP Board runs the national Milk Mustache "got milk?"(R) Campaign, a multi-faceted campaign designed to educate consumers about the health benefits of milk. For more information, go to www.whymilk.com. Lowe New York is the creative agency for the national Milk Mustache "got milk?" Campaign.
Hispanics encouraged to buckle up
New seatbelt ad targets Hispanics, en Español
by: Chris Vanderveen
DENVER - A state senator who has long criticized this country's immigration policies is now upset with a new public service campaign initiated by the Colorado Department of Transportation designed to encourage more seatbelt usage.
Advertisement
"It's part of a trend that I see," Sen. Dave Schultheis (R-Colo. Springs) said on Tuesday. "I just don't think this is part of (the government's) role."
Earlier in the day CDOT unveiled a new PSA campaign designed to target Spanish-speaking audiences.
"It's a message that is educational and both culturally and linguistically relevant," said Laura Sonderup, the director of Hispanidad, the Denver-based agency which produced the campaign.
The PSA attempts to target Hispanic drivers at a time when national statistics suggest they are using seatbelts and child restraints at a rate below the national average.
"The ultimate goal is to reduce the number of fatalities on our highways and byways," Colorado State Trooper Gilbert Mares said. "We want to get the word out in the Spanish language."
On Tuesday, Schultheis not only questioned the campaign's $15,000 price tag, but openly wondered if the campaign will send the wrong message.
"In reality, while we're trying to do this to help people who speak a different language, it will, in the end, not help them," he said. "I want every legal person who speaks a different language to assimilate as quickly as possible, because when you do that you can function in society better."
The ad could start running on Spanish-speaking television stations at any time.
by: Chris Vanderveen
DENVER - A state senator who has long criticized this country's immigration policies is now upset with a new public service campaign initiated by the Colorado Department of Transportation designed to encourage more seatbelt usage.
Advertisement
"It's part of a trend that I see," Sen. Dave Schultheis (R-Colo. Springs) said on Tuesday. "I just don't think this is part of (the government's) role."
Earlier in the day CDOT unveiled a new PSA campaign designed to target Spanish-speaking audiences.
"It's a message that is educational and both culturally and linguistically relevant," said Laura Sonderup, the director of Hispanidad, the Denver-based agency which produced the campaign.
The PSA attempts to target Hispanic drivers at a time when national statistics suggest they are using seatbelts and child restraints at a rate below the national average.
"The ultimate goal is to reduce the number of fatalities on our highways and byways," Colorado State Trooper Gilbert Mares said. "We want to get the word out in the Spanish language."
On Tuesday, Schultheis not only questioned the campaign's $15,000 price tag, but openly wondered if the campaign will send the wrong message.
"In reality, while we're trying to do this to help people who speak a different language, it will, in the end, not help them," he said. "I want every legal person who speaks a different language to assimilate as quickly as possible, because when you do that you can function in society better."
The ad could start running on Spanish-speaking television stations at any time.
Tuesday, January 27, 2009
Obama applauded for clean air ruling
Statement on Presidential Memorandum to EPA to Review Lifting of Ban on California Clean Car Standard
PRESS RELEASE
WASHINGTON, DC - All people have the right to clean air. "Action announced by the White House today means that Americans may soon be able to breathe easier," said Dr. Jane L. Delgado, President and CEO of the National Alliance for Hispanic Health, the nation's leading Hispanic health advocacy group.
We congratulate President Obama on issuing a Presidential Memorandum to the Environmental Protection Agency (EPA) to review the agency's denial of the State of California's request to enact more stringent standards for polluting car emissions under California's Clean Cars Law (AB 1493). If those standards were implemented they would reduce car pollutants by more than one-quarter once fully phased-in by 2016.
The change would not only have an impact in California, but in thirteen other states and the District of Columbia that have already adopted the California standard and are awaiting waivers to enact those standards. This change is critical to the health of Hispanic communities as half of the U.S. Hispanic population lives in states seeking to adopt the stricter California Clean Car emission standard. Research has shown that cleaning our air reduces respiratory disease, cancer incidence, and heart attack.
The Alliance is committed to securing the right of all communities to clean air. Teams of community residents under our Health and Environment Action Network (HEAN), using cutting edge mobile monitors, have shown higher pollution rates near heavily trafficked highways and bridges in Hispanic communities, endangering health and well-being. The Alliance will be a major presence in the upcoming EPA public comment process to implement more stringent car emission standards and invites concerned residents to join us on our action network (http://www.hispanichealth.org/hean/).
PRESS RELEASE
WASHINGTON, DC - All people have the right to clean air. "Action announced by the White House today means that Americans may soon be able to breathe easier," said Dr. Jane L. Delgado, President and CEO of the National Alliance for Hispanic Health, the nation's leading Hispanic health advocacy group.
We congratulate President Obama on issuing a Presidential Memorandum to the Environmental Protection Agency (EPA) to review the agency's denial of the State of California's request to enact more stringent standards for polluting car emissions under California's Clean Cars Law (AB 1493). If those standards were implemented they would reduce car pollutants by more than one-quarter once fully phased-in by 2016.
The change would not only have an impact in California, but in thirteen other states and the District of Columbia that have already adopted the California standard and are awaiting waivers to enact those standards. This change is critical to the health of Hispanic communities as half of the U.S. Hispanic population lives in states seeking to adopt the stricter California Clean Car emission standard. Research has shown that cleaning our air reduces respiratory disease, cancer incidence, and heart attack.
The Alliance is committed to securing the right of all communities to clean air. Teams of community residents under our Health and Environment Action Network (HEAN), using cutting edge mobile monitors, have shown higher pollution rates near heavily trafficked highways and bridges in Hispanic communities, endangering health and well-being. The Alliance will be a major presence in the upcoming EPA public comment process to implement more stringent car emission standards and invites concerned residents to join us on our action network (http://www.hispanichealth.org/hean/).
Hispanics and type 2 diabetes
What is Type 2 Diabetes
FSMT.org
Type 2 diabetes is more common in older people, especially in people who are overweight, cardiochek occurs more often in African Americans, American Indians, some Asian Americans, Native Hawaiians cardiochek other Pacific Islcardiocheker Americans, cardiochek Hispanics/Latinos. On average, non-Hispanic African Americans are 1.8 times as likely to have diabetes as non-Hispanic whites of the same age. Mexican Americans are 1.7 times as likely to have diabetes as non-Hispanic whites of similar age. (Data are not available for estimation of diabetes rates in other Hispanic/Latino groups.) American Indians have one of the highest rates of diabetes in the world. On average, American Indians cardiochek Alaska Natives are 2.2 times as likely to have diabetes as non-Hispanic whites of similar age. Although prevalence data for diabetes among Asian Americans cardiochek Pacific Islcardiochekers are limited, some groups, such as Native Hawaiians, Asians, cardiochek other Pacific Islcardiochekers residing in Hawaii (aged 20 or older) are more than twice as likely to have diabetes as white residents of Hawaii of similar age.
FSMT.org
Type 2 diabetes is more common in older people, especially in people who are overweight, cardiochek occurs more often in African Americans, American Indians, some Asian Americans, Native Hawaiians cardiochek other Pacific Islcardiocheker Americans, cardiochek Hispanics/Latinos. On average, non-Hispanic African Americans are 1.8 times as likely to have diabetes as non-Hispanic whites of the same age. Mexican Americans are 1.7 times as likely to have diabetes as non-Hispanic whites of similar age. (Data are not available for estimation of diabetes rates in other Hispanic/Latino groups.) American Indians have one of the highest rates of diabetes in the world. On average, American Indians cardiochek Alaska Natives are 2.2 times as likely to have diabetes as non-Hispanic whites of similar age. Although prevalence data for diabetes among Asian Americans cardiochek Pacific Islcardiochekers are limited, some groups, such as Native Hawaiians, Asians, cardiochek other Pacific Islcardiochekers residing in Hawaii (aged 20 or older) are more than twice as likely to have diabetes as white residents of Hawaii of similar age.
Sunday, January 25, 2009
Hispanic blood donors being recruited
Center recruiting more Hispanic blood donors
Marissa Villa - Conexión
The potential that Hispanics have in saving lives may not be widely known, which could be why only a third of South Texas Blood and Tissue Center donors are Hispanic.
More than half of all Hispanics may carry what is known as the universal blood type, O negative, according to research by the University of Texas at Galveston. However, because of many misconceptions among Latinos, nationwide less than 6 percent of Hispanics who are eligible to donate actually do.
Because these numbers are so low, STBTC has launched a campaign called Mi Sangre Es Tu Sangre in order to recruit more Hispanics for blood donation.
“We really just want to open up the dialog (about donation),” said Aleida Fuentes, spokeswoman for STBTC.
In addition to a general marketing campaign that promotes unity, health and action among the Hispanic community, STBTC provides tools that help donors keep track of health information.
“We want to plant that seed that blood donation is needed,” Fuentes said.
The local center serves more than 100 hospitals and clinics in 43 counties, which are primarily Hispanic.
But the typical donors are repeat donors who started giving at a young age. So, while the Hispanic population grows, so does the need for blood. However, the number of donors tends to stay the same.
For each pint of blood that is donated, three lives have the potential of being impacted, Fuentes said.
Some recipients of blood donations include trauma victims, diabetics, premature infants and cancer patients.
However, because of misconceptions about blood donation many don't see the potential saving benefits.
“The biggest (myth) is ‘I'm going to gain weight if I donate blood,'” Fuentes said. “The other is ‘I'm going to get sick.'”
But like receiving blood, giving blood is safe, she said.
“Within our community there's a big mistrust of (health providers) in general,” Fuentes said.
Other myths that hold Hispanics back from donating blood also include “Since I have diabetes, I can't donate blood” and “I am too old to donate blood.”
Diabetics can donate as long as they haven't switched medication within the last two weeks. Donors must be at least 17 years old, weigh at least 110 pounds and be in good health.
The campaign will aim to calm any doubts, and further health education, including cholesterol and hemoglobin level education.
Anyone interested in learning more about Mi Sangre Es Tu Sangre can log on to www.southtexasblood.org/MiSangreEsTuSangre.asp for more information.
Marissa Villa - Conexión
The potential that Hispanics have in saving lives may not be widely known, which could be why only a third of South Texas Blood and Tissue Center donors are Hispanic.
More than half of all Hispanics may carry what is known as the universal blood type, O negative, according to research by the University of Texas at Galveston. However, because of many misconceptions among Latinos, nationwide less than 6 percent of Hispanics who are eligible to donate actually do.
Because these numbers are so low, STBTC has launched a campaign called Mi Sangre Es Tu Sangre in order to recruit more Hispanics for blood donation.
“We really just want to open up the dialog (about donation),” said Aleida Fuentes, spokeswoman for STBTC.
In addition to a general marketing campaign that promotes unity, health and action among the Hispanic community, STBTC provides tools that help donors keep track of health information.
“We want to plant that seed that blood donation is needed,” Fuentes said.
The local center serves more than 100 hospitals and clinics in 43 counties, which are primarily Hispanic.
But the typical donors are repeat donors who started giving at a young age. So, while the Hispanic population grows, so does the need for blood. However, the number of donors tends to stay the same.
For each pint of blood that is donated, three lives have the potential of being impacted, Fuentes said.
Some recipients of blood donations include trauma victims, diabetics, premature infants and cancer patients.
However, because of misconceptions about blood donation many don't see the potential saving benefits.
“The biggest (myth) is ‘I'm going to gain weight if I donate blood,'” Fuentes said. “The other is ‘I'm going to get sick.'”
But like receiving blood, giving blood is safe, she said.
“Within our community there's a big mistrust of (health providers) in general,” Fuentes said.
Other myths that hold Hispanics back from donating blood also include “Since I have diabetes, I can't donate blood” and “I am too old to donate blood.”
Diabetics can donate as long as they haven't switched medication within the last two weeks. Donors must be at least 17 years old, weigh at least 110 pounds and be in good health.
The campaign will aim to calm any doubts, and further health education, including cholesterol and hemoglobin level education.
Anyone interested in learning more about Mi Sangre Es Tu Sangre can log on to www.southtexasblood.org/MiSangreEsTuSangre.asp for more information.
Hispanics do not respond well to Hep C drugs
Hepatitis C drugs work less well for Hispanics
In study They helped 34%, compared with 49% of whites
By Bob LaMendola - South Florida Sun Sentinel
FORT LAUDERDALE, Fla. — The most effective treatment for hepatitis C fails in two-thirds of Hispanic patients but for only half of white patients, researchers reported Wednesday in a study that confirms ethnic disparities in the liver disease.
The study follows earlier research showing that the drug combination used to treat the hepatitis C virus fails for almost three-quarters of black patients. Doctors said unknown biological differences might diminish the success of the drugs in minority patients.
“There may be factors in individuals, in their immune response, that may be related to their ethnicity,” said Dr. Paul Martin, senior author of the study and chief of liver diseases at the University of Miami medical school.
Click here to find out more!
Doctors and hepatitis advocates said patients should not give up on the drugs. The combination — pegylated interferon plus ribavirin — is a step up from a decade ago, when drugs worked in only 10 percent. New and better drugs are in the works.
Hepatitis C is a leading cause of liver cancer and cirrhosis, and it has fueled a jump in liver transplants. The virus spreads in blood, mainly via injection drug use and transfusions before 1992.
About 4 million nationally have chronic hepatitis C. A blood test can detect the virus, and the drug combination can eradicate it — when it works.
The new study in the New England Journal of Medicine gave the drugs to 269 Hispanic patients and 300 white patients for a year. They were deemed a success if they were virus-free six months after that.
The drugs worked for 49 percent of white patients but only 34 percent of Hispanic patients. The Hispanics never got rid of the virus, or it returned.
“It's probably genetic or biology,” said Dr. Lennox Jeffers, chief of liver disease at the Veterans Affairs Medical Center in Miami, who worked on this study and two with black patients.
In study They helped 34%, compared with 49% of whites
By Bob LaMendola - South Florida Sun Sentinel
FORT LAUDERDALE, Fla. — The most effective treatment for hepatitis C fails in two-thirds of Hispanic patients but for only half of white patients, researchers reported Wednesday in a study that confirms ethnic disparities in the liver disease.
The study follows earlier research showing that the drug combination used to treat the hepatitis C virus fails for almost three-quarters of black patients. Doctors said unknown biological differences might diminish the success of the drugs in minority patients.
“There may be factors in individuals, in their immune response, that may be related to their ethnicity,” said Dr. Paul Martin, senior author of the study and chief of liver diseases at the University of Miami medical school.
Click here to find out more!
Doctors and hepatitis advocates said patients should not give up on the drugs. The combination — pegylated interferon plus ribavirin — is a step up from a decade ago, when drugs worked in only 10 percent. New and better drugs are in the works.
Hepatitis C is a leading cause of liver cancer and cirrhosis, and it has fueled a jump in liver transplants. The virus spreads in blood, mainly via injection drug use and transfusions before 1992.
About 4 million nationally have chronic hepatitis C. A blood test can detect the virus, and the drug combination can eradicate it — when it works.
The new study in the New England Journal of Medicine gave the drugs to 269 Hispanic patients and 300 white patients for a year. They were deemed a success if they were virus-free six months after that.
The drugs worked for 49 percent of white patients but only 34 percent of Hispanic patients. The Hispanics never got rid of the virus, or it returned.
“It's probably genetic or biology,” said Dr. Lennox Jeffers, chief of liver disease at the Veterans Affairs Medical Center in Miami, who worked on this study and two with black patients.
Hispanics targeted for oral cancer screening
Oral cancer screening reaches Hispanic community
By LOIS BAKER January 16, 2009
“Boca Sana Cuerpo Sano,” said the flyer posted in the Judge J. Mattina Community Health Center on Buffalo’s largely Hispanic Lower West Side: “Healthy Mouth Healthy Body.”
It alerted the community to the upcoming free oral-cancer screening at the clinic conducted by faculty, dental residents and students from the UB School of Dental Medicine.
More than 100 people from the surrounding neighborhood showed up during the two-day event to have their teeth checked for cavities and their mouths for gum disease and signs of oral cancer. Some were regular patients at the health center; some were not, but they came anyway and brought family members. Five patients were found to have suspicious lesions.
“We were bombarded,” says Yoly Gonzalez, the event’s founder. “People wanted to be screened. They brought their relatives. They didn’t come for the free toothbrush and toothpaste.”
This was the screening’s fifth year—and the most well-attended yet—but it wasn’t always so successful. Gonzalez, UB clinical assistant professor of oral diagnostic sciences, and a cadre of students, residents and faculty members had to do a bit of cajoling to get the project started.
A native of Venezuela, Gonzalez earned a dental degree from the Universidad Central de Venezuela in Caracas, where the fifth year of study was devoted to community service. She spent six months working with the Guajiros and Piaroas Indians in the Venezuelan jungle. But when Gonzalez joined the UB dental school faculty, she found a void.
“In Venezuela, we were always linked to the community. Here, we didn’t have a connection,” she says.
The West Side health center, established by Kaleida Health to serve the Hispanic community, was the logical place to create such a connection, so Gonzalez paid a visit and brought along a few students.
Energized by the experience, the students formed a chapter of the Hispanic Dental Association. Wanting to do something other than sponsor parties, the members decided to conduct a yearly free oral-cancer screening at the clinic.
That first year, Gonzalez and a small UB team, with the support of Rene Perez-Bode, the clinic’s full-time dentist, set up tables in the clinic lobby stocked with information on dental health and oral cancer.
“It was a very slow beginning,” Gonzalez recalls. “Many people didn’t even know there was such a thing as oral cancer. They’d say, ‘You can get cancer in your mouth?’”
Volunteers took a brief medical history of those initial patients to make sure they weren’t afraid of dentists or allergic to the latex gloves worn by examiners. If something suspicious was detected by an examiner, Gonzalez made an appointment for the patient at the UB dental school clinic.
The following year, the volunteers added a table on smoking cessation. With funds from a New York State Quit Line grant, they gave away toothbrushes, toothpaste, apples and bottled water. The names of smokers who were ready to quit were passed along to the Quit Line, which provided two weeks of nicotine-replacement patches and continued encouragement.
Attendance at the yearly event increased gradually. “It’s been an effort from the heart,” Gonzalez says. “It grew little by little.”
This year, a team of 10 students, faculty and staff screened more than 50 patients a day over the two-day event. Heidi Crow, associate professor of oral diagnostic sciences, had joined the group and there now were three dental chairs at the clinic—two for routine screenings and a third for patients whose teeth needed immediate attention.
The team’s next step is to raise money for patients who fall into the gap—those who can’t afford dental insurance but aren’t eligible for Medicare. Team members also would like to conduct screenings twice a year to reach more people.
A visit to the most recent screening by Mark King, president of the American Cancer Society’s regional board of advisors, may help that effort. Impressed by the event, King wants to take the UB model for oral-cancer screening to other communities and raise funds to support those efforts.
“Our main objective is to provide a service to our local community,” Gonzalez stresses. “It’s wonderful to help people anywhere, but we have needs right here.”
By LOIS BAKER January 16, 2009
“Boca Sana Cuerpo Sano,” said the flyer posted in the Judge J. Mattina Community Health Center on Buffalo’s largely Hispanic Lower West Side: “Healthy Mouth Healthy Body.”
It alerted the community to the upcoming free oral-cancer screening at the clinic conducted by faculty, dental residents and students from the UB School of Dental Medicine.
More than 100 people from the surrounding neighborhood showed up during the two-day event to have their teeth checked for cavities and their mouths for gum disease and signs of oral cancer. Some were regular patients at the health center; some were not, but they came anyway and brought family members. Five patients were found to have suspicious lesions.
“We were bombarded,” says Yoly Gonzalez, the event’s founder. “People wanted to be screened. They brought their relatives. They didn’t come for the free toothbrush and toothpaste.”
This was the screening’s fifth year—and the most well-attended yet—but it wasn’t always so successful. Gonzalez, UB clinical assistant professor of oral diagnostic sciences, and a cadre of students, residents and faculty members had to do a bit of cajoling to get the project started.
A native of Venezuela, Gonzalez earned a dental degree from the Universidad Central de Venezuela in Caracas, where the fifth year of study was devoted to community service. She spent six months working with the Guajiros and Piaroas Indians in the Venezuelan jungle. But when Gonzalez joined the UB dental school faculty, she found a void.
“In Venezuela, we were always linked to the community. Here, we didn’t have a connection,” she says.
The West Side health center, established by Kaleida Health to serve the Hispanic community, was the logical place to create such a connection, so Gonzalez paid a visit and brought along a few students.
Energized by the experience, the students formed a chapter of the Hispanic Dental Association. Wanting to do something other than sponsor parties, the members decided to conduct a yearly free oral-cancer screening at the clinic.
That first year, Gonzalez and a small UB team, with the support of Rene Perez-Bode, the clinic’s full-time dentist, set up tables in the clinic lobby stocked with information on dental health and oral cancer.
“It was a very slow beginning,” Gonzalez recalls. “Many people didn’t even know there was such a thing as oral cancer. They’d say, ‘You can get cancer in your mouth?’”
Volunteers took a brief medical history of those initial patients to make sure they weren’t afraid of dentists or allergic to the latex gloves worn by examiners. If something suspicious was detected by an examiner, Gonzalez made an appointment for the patient at the UB dental school clinic.
The following year, the volunteers added a table on smoking cessation. With funds from a New York State Quit Line grant, they gave away toothbrushes, toothpaste, apples and bottled water. The names of smokers who were ready to quit were passed along to the Quit Line, which provided two weeks of nicotine-replacement patches and continued encouragement.
Attendance at the yearly event increased gradually. “It’s been an effort from the heart,” Gonzalez says. “It grew little by little.”
This year, a team of 10 students, faculty and staff screened more than 50 patients a day over the two-day event. Heidi Crow, associate professor of oral diagnostic sciences, had joined the group and there now were three dental chairs at the clinic—two for routine screenings and a third for patients whose teeth needed immediate attention.
The team’s next step is to raise money for patients who fall into the gap—those who can’t afford dental insurance but aren’t eligible for Medicare. Team members also would like to conduct screenings twice a year to reach more people.
A visit to the most recent screening by Mark King, president of the American Cancer Society’s regional board of advisors, may help that effort. Impressed by the event, King wants to take the UB model for oral-cancer screening to other communities and raise funds to support those efforts.
“Our main objective is to provide a service to our local community,” Gonzalez stresses. “It’s wonderful to help people anywhere, but we have needs right here.”
Acculturated Latinos at risk to sun exposure
Sun Safety Suffers When Latinos Assimilate into U.S. Culture
By Peggy Peck, Executive Editor, MedPage Today January 16, 2009
ALHAMBRA, Calif., Jan. 16 -- Risky behavior trumps sun-safe practices when Latino Americans become acculturated to U.S. habits, researchers here reported.
Action Points
* Explain to interested patients that this analysis suggests that adopting American culture may expose U.S. Latinos to increased risk of sun damage.
Latinos who were highly acculturated -- defined primarily by demonstrating comfort with English language -- were less likely to seek the protection of shade or to wear protective clothing than Latinos who were less well assimilated, said Valentina A. Andreeva, Ph.D., of the Keck School of Medicine at the University of Southern California, and colleagues.
But one sun-safety behavior increased with the level of acculturation -- the use of sunscreen, which was positively associated with acculturation (P<0.004), they reported online in the American Journal of Public Health.
The authors concluded that sun safety education for Latinos should "target acculturation, age, and [socioeconomic status] factors."
In the U.S. the overall rate of new diagnoses of malignant melanoma rose 3.1% a year from 1992 through 2004, with statistically significant increases for every histologic type and thickness, according to findings published earlier this month. (See: Reports of Increases in Melanoma Incidence Are Real)
Meanwhile, the annual age-adjusted incidence of melanoma among Latinos increased by 32.4% from 3.7 per 100,000 in the 1992 to 1996 period to 4.9 per 100,000 in the period 2001 to 2005.
Moreover, "Latinos experience more advanced tumors with a poorer prognosis than do non-Latino whites, possibly because they have less awareness about risk factors or symptoms, are more likely to lack health insurance, are not targeted in melanoma-screening efforts, and may delay seeking treatment," Dr. Andreeva wrote.
Recent studies have also documented an increase in risk of sunburn among Latinos, with 45.6% of adult Latinos reporting one or more annual sunburn episodes versus 35.6% of non-Latino whites who said they were sunburned at least once a year.
Because declines in sun-safe behaviors have been suggested as a possible explanation for the increase in melanoma, Dr. Andreeva and colleagues sought to determine the effect of acculturation on sun-safe behaviors among Latinos.
They analyzed data from 496 Latino respondents to the 2005 Health Information National Trends Survey.
Frequency of sunscreen use, seeking shade, and use of protective clothing were the primary outcome measures.
Acculturation was defined as the "process of interchange by which immigrants accommodate the language, behaviors, and norms predominant in the host country."
Acculturation measures were place of birth and interview language, as well as perceived comfort with English ranging from completely comfortable to do not speak English. Additionally, Dr. Andreeva and colleagues applied two continuous variables to all foreign-born respondents -- age at arrival in the U.S. and duration of U.S. residence.
The mean age of the sample was 41 and 61.5% were women. A little more than a third were born in the U.S. and 54.6% were interviewed in Spanish.
The researchers analyzed endpoints based on both demographic factors and on the basis of acculturation.
Among the findings:
* Women were more likely to use sunscreen and seek shade (P<0.001) and men were more likely to use protective clothing (P<0.02).
* Older age was positively associated with use of protective clothing (P<0.05).
* Education was positively associated with sunscreen use (P<0.001), but negatively associated with use of protective clothing (P<0.03).
* Respondents who had health insurance were less likely to use protective clothing (P<0.05 for long-sleeved shirts and P<0.001for wearing long pants, but were more likely to use sunscreen (P<0.02).
* Greater acculturation increased the likelihood of using sunscreen (P<0.01), but was negatively associated with seeking shade (P<0.002), wearing long-sleeved shirts (P<0.001) or long pants (P<0.001).
* There was no association between wearing hats and acculturation.
The authors said the study was limited by the small number of Latinos included in the national survey -- just 9% of the total sample. They also noted that the responses were collected via telephone survey using landlines, which may have lead to selection bias and that they were unable to assess darker versus lighter skin color in the respondents.
Also, the authors acknowledged that there were a number of potential methodological flaws in the method used to assess acculturation, including the reliance on the mean of all available variables for all participants to calculate an acculturation index.
They noted that more research on the subject was needed.
Dr. Andreeva made no disclosures and no funding source was cited.
By Peggy Peck, Executive Editor, MedPage Today January 16, 2009
ALHAMBRA, Calif., Jan. 16 -- Risky behavior trumps sun-safe practices when Latino Americans become acculturated to U.S. habits, researchers here reported.
Action Points
* Explain to interested patients that this analysis suggests that adopting American culture may expose U.S. Latinos to increased risk of sun damage.
Latinos who were highly acculturated -- defined primarily by demonstrating comfort with English language -- were less likely to seek the protection of shade or to wear protective clothing than Latinos who were less well assimilated, said Valentina A. Andreeva, Ph.D., of the Keck School of Medicine at the University of Southern California, and colleagues.
But one sun-safety behavior increased with the level of acculturation -- the use of sunscreen, which was positively associated with acculturation (P<0.004), they reported online in the American Journal of Public Health.
The authors concluded that sun safety education for Latinos should "target acculturation, age, and [socioeconomic status] factors."
In the U.S. the overall rate of new diagnoses of malignant melanoma rose 3.1% a year from 1992 through 2004, with statistically significant increases for every histologic type and thickness, according to findings published earlier this month. (See: Reports of Increases in Melanoma Incidence Are Real)
Meanwhile, the annual age-adjusted incidence of melanoma among Latinos increased by 32.4% from 3.7 per 100,000 in the 1992 to 1996 period to 4.9 per 100,000 in the period 2001 to 2005.
Moreover, "Latinos experience more advanced tumors with a poorer prognosis than do non-Latino whites, possibly because they have less awareness about risk factors or symptoms, are more likely to lack health insurance, are not targeted in melanoma-screening efforts, and may delay seeking treatment," Dr. Andreeva wrote.
Recent studies have also documented an increase in risk of sunburn among Latinos, with 45.6% of adult Latinos reporting one or more annual sunburn episodes versus 35.6% of non-Latino whites who said they were sunburned at least once a year.
Because declines in sun-safe behaviors have been suggested as a possible explanation for the increase in melanoma, Dr. Andreeva and colleagues sought to determine the effect of acculturation on sun-safe behaviors among Latinos.
They analyzed data from 496 Latino respondents to the 2005 Health Information National Trends Survey.
Frequency of sunscreen use, seeking shade, and use of protective clothing were the primary outcome measures.
Acculturation was defined as the "process of interchange by which immigrants accommodate the language, behaviors, and norms predominant in the host country."
Acculturation measures were place of birth and interview language, as well as perceived comfort with English ranging from completely comfortable to do not speak English. Additionally, Dr. Andreeva and colleagues applied two continuous variables to all foreign-born respondents -- age at arrival in the U.S. and duration of U.S. residence.
The mean age of the sample was 41 and 61.5% were women. A little more than a third were born in the U.S. and 54.6% were interviewed in Spanish.
The researchers analyzed endpoints based on both demographic factors and on the basis of acculturation.
Among the findings:
* Women were more likely to use sunscreen and seek shade (P<0.001) and men were more likely to use protective clothing (P<0.02).
* Older age was positively associated with use of protective clothing (P<0.05).
* Education was positively associated with sunscreen use (P<0.001), but negatively associated with use of protective clothing (P<0.03).
* Respondents who had health insurance were less likely to use protective clothing (P<0.05 for long-sleeved shirts and P<0.001for wearing long pants, but were more likely to use sunscreen (P<0.02).
* Greater acculturation increased the likelihood of using sunscreen (P<0.01), but was negatively associated with seeking shade (P<0.002), wearing long-sleeved shirts (P<0.001) or long pants (P<0.001).
* There was no association between wearing hats and acculturation.
The authors said the study was limited by the small number of Latinos included in the national survey -- just 9% of the total sample. They also noted that the responses were collected via telephone survey using landlines, which may have lead to selection bias and that they were unable to assess darker versus lighter skin color in the respondents.
Also, the authors acknowledged that there were a number of potential methodological flaws in the method used to assess acculturation, including the reliance on the mean of all available variables for all participants to calculate an acculturation index.
They noted that more research on the subject was needed.
Dr. Andreeva made no disclosures and no funding source was cited.
Latino smokers have trouble quiting menthol cigarettes
Menthol cigarettes may be tougher for some to quit
By Amy Norton Jan 21, 2009
NEW YORK (Reuters Health) - Menthol cigarettes may be harder to quit than the standard variety, particularly for lower-income smokers, a new study suggests.
The findings add to evidence that mentholated cigarettes may be especially addictive, but highlight a role for socioeconomics as well, researchers say.
They found that black and Hispanic smokers who favored menthol cigarettes had lower long-term quit rates than their counterparts who smoked standard cigarettes. There was no such difference among white smokers overall, but there was a pattern among unemployed whites: those who smoked menthol cigarettes had lower quit rates at one month.
Previous research has found that menthol-cigarette smokers tend to have higher blood levels of nicotine than other smokers do.
"This study suggests that people who smoke mentholated cigarettes -- particularly those with a low disposable income -- may inhale more nicotine and toxins per cigarette," lead researcher Kunal K. Gandhi told Reuters Health.
This, in turn, may spur a stronger addiction, explained Gandhi, a researcher at University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School in New Brunswick, New Jersey.
Income may enter the picture, Gandhi and his colleagues say, by altering the way in which people smoke. Low-income smokers may try to get more out of each smoke break by taking more puffs per cigarette or inhaling more deeply.
Menthol makes this an easier task because its cooling effect helps mask the harshness of nicotine and other tobacco toxins.
The findings, published in the International Journal of Clinical Practice, are based on 1,688 smokers who sought cessation therapy over four years. One-third of white patients smoked menthol cigarettes, compared with two-thirds of Latino patients and 81 percent of African Americans.
Among black patients, Gandhi's team found, menthol-cigarette smokers were only one-third as likely to have quit smoking after one month as those who smoked non-menthol cigarettes. The findings were nearly identical among Latinos.
Menthol smokers were still less likely to have quit at the six-month mark as well.
People who smoke mentholated cigarettes may find themselves highly addicted even if their daily number of cigarettes is relatively low, Gandhi noted. Signs of strong addiction, he added, include waking up at night to smoke and needing a cigarette within a half-hour of getting up in the morning.
For any smoker, Gandhi said, the chances of quitting are much greater with counseling and with prescription medications for conquering nicotine addiction.
SOURCE: International Journal of Clinical Practice, February 2009.
By Amy Norton Jan 21, 2009
NEW YORK (Reuters Health) - Menthol cigarettes may be harder to quit than the standard variety, particularly for lower-income smokers, a new study suggests.
The findings add to evidence that mentholated cigarettes may be especially addictive, but highlight a role for socioeconomics as well, researchers say.
They found that black and Hispanic smokers who favored menthol cigarettes had lower long-term quit rates than their counterparts who smoked standard cigarettes. There was no such difference among white smokers overall, but there was a pattern among unemployed whites: those who smoked menthol cigarettes had lower quit rates at one month.
Previous research has found that menthol-cigarette smokers tend to have higher blood levels of nicotine than other smokers do.
"This study suggests that people who smoke mentholated cigarettes -- particularly those with a low disposable income -- may inhale more nicotine and toxins per cigarette," lead researcher Kunal K. Gandhi told Reuters Health.
This, in turn, may spur a stronger addiction, explained Gandhi, a researcher at University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School in New Brunswick, New Jersey.
Income may enter the picture, Gandhi and his colleagues say, by altering the way in which people smoke. Low-income smokers may try to get more out of each smoke break by taking more puffs per cigarette or inhaling more deeply.
Menthol makes this an easier task because its cooling effect helps mask the harshness of nicotine and other tobacco toxins.
The findings, published in the International Journal of Clinical Practice, are based on 1,688 smokers who sought cessation therapy over four years. One-third of white patients smoked menthol cigarettes, compared with two-thirds of Latino patients and 81 percent of African Americans.
Among black patients, Gandhi's team found, menthol-cigarette smokers were only one-third as likely to have quit smoking after one month as those who smoked non-menthol cigarettes. The findings were nearly identical among Latinos.
Menthol smokers were still less likely to have quit at the six-month mark as well.
People who smoke mentholated cigarettes may find themselves highly addicted even if their daily number of cigarettes is relatively low, Gandhi noted. Signs of strong addiction, he added, include waking up at night to smoke and needing a cigarette within a half-hour of getting up in the morning.
For any smoker, Gandhi said, the chances of quitting are much greater with counseling and with prescription medications for conquering nicotine addiction.
SOURCE: International Journal of Clinical Practice, February 2009.
Latino bone marrow donors wanted
Donor program reaching out to Latino community
By J.M. Brown Correspondent 01/22/2009
The Alameda-based Asian American Donor Program is expanding its outreach to the Latino community in order to give Hispanic people greater access to bone marrow matches.
The organization, which was founded 20 years ago to encourage more Asian Americans to register on the national bone marrow database, decided to create a Latino Outreach Program after 24-year-old leukemia patient Jose Ochoa contacted the group for help in August. The Asian American Donor Program had helped other Latino patients in the past, but realized a need to serve the nation's growing Hispanic population.
Patients needing bone marrow transplants can only be matched with donors of the same or similar ethnic makeup, creating a need for ethnic minorities and multi-ethnic people to donate. As of September, only 5.3 percent of donors on the national registry identified as people of Hispanic origin, compared to 73 percent Caucasian.
To celebrate the public service aspect of Monday's Martin Luther King Jr. Day and Tuesday's inauguration of Barack Obama, the Asian American Donor Program hosted donor drives in Oakland.
Ramona Garcia, who the group recently hired to conduct its Latino Outreach Program, was at the drives to help Latinos understand why their help is so critical.
There are several cultural barriers to getting more Latino people to donate, Garcia said. There is some distrust of medical providers and concern among undocumented donors that providing
identification information may lead trouble with authorities.
"There area lot of myths people have about surgery "... because people have their own ways of remedy and illness and solutions to it," Garcia said. "It's really about bringing awareness to the community and informing people." Stem cells can be used to treat 167 kinds of blood diseases, from leukemia to lymphoma. Registering on the donor list requires filling out a medical survey and taking four cheek swabs. Donors are asked to extract stem cells only if there is a match. The recipient's health insurance or the national donor program will cover the cost of the procedure.
For information, contact Garcia at the AADP at 800-593-6667, visit the center at 2169 Harbor Bay Parkway, Alameda, or log on to www.aadp.org.
Contact J.M. Brown at jammbrow@yahoo.com.
By J.M. Brown Correspondent 01/22/2009
The Alameda-based Asian American Donor Program is expanding its outreach to the Latino community in order to give Hispanic people greater access to bone marrow matches.
The organization, which was founded 20 years ago to encourage more Asian Americans to register on the national bone marrow database, decided to create a Latino Outreach Program after 24-year-old leukemia patient Jose Ochoa contacted the group for help in August. The Asian American Donor Program had helped other Latino patients in the past, but realized a need to serve the nation's growing Hispanic population.
Patients needing bone marrow transplants can only be matched with donors of the same or similar ethnic makeup, creating a need for ethnic minorities and multi-ethnic people to donate. As of September, only 5.3 percent of donors on the national registry identified as people of Hispanic origin, compared to 73 percent Caucasian.
To celebrate the public service aspect of Monday's Martin Luther King Jr. Day and Tuesday's inauguration of Barack Obama, the Asian American Donor Program hosted donor drives in Oakland.
Ramona Garcia, who the group recently hired to conduct its Latino Outreach Program, was at the drives to help Latinos understand why their help is so critical.
There are several cultural barriers to getting more Latino people to donate, Garcia said. There is some distrust of medical providers and concern among undocumented donors that providing
identification information may lead trouble with authorities.
"There area lot of myths people have about surgery "... because people have their own ways of remedy and illness and solutions to it," Garcia said. "It's really about bringing awareness to the community and informing people." Stem cells can be used to treat 167 kinds of blood diseases, from leukemia to lymphoma. Registering on the donor list requires filling out a medical survey and taking four cheek swabs. Donors are asked to extract stem cells only if there is a match. The recipient's health insurance or the national donor program will cover the cost of the procedure.
For information, contact Garcia at the AADP at 800-593-6667, visit the center at 2169 Harbor Bay Parkway, Alameda, or log on to www.aadp.org.
Contact J.M. Brown at jammbrow@yahoo.com.
Latino diabetes awareness forum planned
Diabetes forum to examine solutions for the Latino community
Marissa Villa - Conexión
Like any other health problem, the outcome of diabetes has very little to do with a physician, but few people realize that. A forum presented by LULAC and the Texas Diabetes Institute will bring diabetes professionals and patients to see what the solutions actually are.
The forum, called the First Annual Educational Forum on Diabetes: A Latinos in Action Initiative, is a two-day workshop that will allow patients to speak about the challenges they face. The forum is scheduled for Friday and Saturday at the University Center for Community Health, 701 S. Zarzamora St.
“It's going to be a good dialog and exchange of information,” said Terri De La Haya, senior vice president of clinical preventive services for the Texas Diabetes Institute.
The forum, which will be held from 9 a.m.-3 p.m. on Friday and 9-11 a.m. on Saturday, will look at the solutions to diabetes.
“Unfortunately if you look at all the illnesses that are affecting our community, they all stem from the same problem — healthy choices,” De La Haya said.
De La Haya said research has shown that 50 percent of health outcomes actually have to do with individual choices. Other factors include environment and genetics. Only 10 percent has to do with a physician, she said.
“But if people don't understand what influences their health, they are totally dependent on that 10 percent,” she said.
The conversation about diabetes will look at how to involve family and make changes in choices that negatively affect health.
The forum also will include a play called “Count my Tortillas,” which is a presentation of Mujeres Unidas.
The play looks at not only the struggles at home with families not being supportive of the lifestyle changes diabetics need to make, but also the problems they have with health-care providers.
De La Haya says the forum is a change from the usual educational classes for diabetics.
“We're always holding sessions, but it's nice for them to let us know what's going on with them,” she said.
LULAC leaders came to the institute to develop an outreach program for Latinos in regard to diabetes because the disease plagues the ethnic group at such a high rate.
“As an organization, they wanted to see what can they do to help in the area of health,” De La Haya said.
The free forum is open to the public. For more information, call (210) 288-1357 or (210) 358-7398.
Marissa Villa - Conexión
Like any other health problem, the outcome of diabetes has very little to do with a physician, but few people realize that. A forum presented by LULAC and the Texas Diabetes Institute will bring diabetes professionals and patients to see what the solutions actually are.
The forum, called the First Annual Educational Forum on Diabetes: A Latinos in Action Initiative, is a two-day workshop that will allow patients to speak about the challenges they face. The forum is scheduled for Friday and Saturday at the University Center for Community Health, 701 S. Zarzamora St.
“It's going to be a good dialog and exchange of information,” said Terri De La Haya, senior vice president of clinical preventive services for the Texas Diabetes Institute.
The forum, which will be held from 9 a.m.-3 p.m. on Friday and 9-11 a.m. on Saturday, will look at the solutions to diabetes.
“Unfortunately if you look at all the illnesses that are affecting our community, they all stem from the same problem — healthy choices,” De La Haya said.
De La Haya said research has shown that 50 percent of health outcomes actually have to do with individual choices. Other factors include environment and genetics. Only 10 percent has to do with a physician, she said.
“But if people don't understand what influences their health, they are totally dependent on that 10 percent,” she said.
The conversation about diabetes will look at how to involve family and make changes in choices that negatively affect health.
The forum also will include a play called “Count my Tortillas,” which is a presentation of Mujeres Unidas.
The play looks at not only the struggles at home with families not being supportive of the lifestyle changes diabetics need to make, but also the problems they have with health-care providers.
De La Haya says the forum is a change from the usual educational classes for diabetics.
“We're always holding sessions, but it's nice for them to let us know what's going on with them,” she said.
LULAC leaders came to the institute to develop an outreach program for Latinos in regard to diabetes because the disease plagues the ethnic group at such a high rate.
“As an organization, they wanted to see what can they do to help in the area of health,” De La Haya said.
The free forum is open to the public. For more information, call (210) 288-1357 or (210) 358-7398.
Latino children impacted by lack of pediatric care
Pediatric care shrinks across California
By Kimi Yoshino January 25, 2009
Within two hours of Roman Rodriguez's birth in Fontana, ambulances rushed him to Childrens Hospital Los Angeles, 50 miles away. State-of-the-art equipment kept the newborn alive as doctors performed five surgeries to repair intestines that had wiggled through a hole in his diaphragm and landed on his right lung.
Roman -- who had spent every day of his young life at the hospital in Hollywood -- was still on oxygen, with more surgery possible, when doctors told his mother in early December that it was time for the 6-week-old infant to leave. They needed his bed for a sicker child. He was transferred to a nearby hospital that dedicates far fewer resources to pediatric care.
"Now it's like he has to start all over again, which is very difficult for us and for him," his mother, Crystal Carmen, said at the time.
Three weeks ago, after five more surgeries, Roman moved yet again, this time back to the hospital in Fontana where he was born.
"It's nicer," Carmen said of the shorter commute. "We just feel that if he [had stayed] at Childrens, he would be home already."
This is the juggling act of pediatric care in California, where parents and medical professionals are grappling with a significantly diminished network of care for the state's 10 million children.
In the last decade, even as the number of children has grown, more than 65 hospitals have either eliminated their children's units or shut down altogether. More than two dozen others have reduced the number of beds for children. Most counties north of Sacramento now lack even a single dedicated pediatric bed.
In all, more than 800 inpatient children's beds were lost from 1998 through 2007 -- a 19% drop, a Times analysis found. More than half of those losses have been in Los Angeles County, where dozens more pediatric beds have been eliminated since. The analysis did not look at intensive care beds for children and infants.
Concentrating children's services at specialized centers can sometimes provide better care. Sick children are not equivalent to smaller-scale adults. Their treatment requires particular training and equipment. But the widespread loss of pediatric beds appears to be driven more by financial pressure than any shift in medical protocol or practice.
Policy experts, nurses and many pediatricians worry that young patients are now concentrated at too few hospitals, even with more children being treated as outpatients.
Hospitals have cut back on services for children without serious, coordinated analysis of how the losses statewide could affect the quality of care, particularly with many regions expecting a population increase. With the economic downturn forcing even more hospitals to the brink of closure, the condition of the children's healthcare system in the state reflects the ad hoc manner in which many decisions affecting life and death are made, according to healthcare experts.
"In California, things are a mess," said pediatrician Paul Wise, a children's health policy researcher at Stanford. "There seems to be a lack of any coherent monitoring or oversight."
Faced with shrinking budgets, many California hospitals have been forced to shift resources toward adults, who receive higher state and federal subsidies. To make matters worse, California's Medi-Cal reimbursement rates for children's healthcare ranks last in the country, said Diana Dooley, chief executive of the California Children's Hospital Assn.
"Some children will be denied the level of care that they need," Dooley said. "They'll have to get no care or they'll have to get care that isn't delivered by . . . pediatricians trained in the special needs of children."
In November, voters approved a $980-million children's hospital bond, which will help pay for construction projects underway or planned. But even that cash infusion won't make up for the beds already lost in what Wise calls an evaporation of pediatric care.
In the Central Valley, hospital closures and population growth have strained Children's Hospital Central California. Serving 10 counties and 45,000 square miles, officials there have set aside six RV parking spaces for patients' families and allow them to tap the hospital's power supply.
In some cases, lack of nearby pediatric care turns relatively simple medical issues into more serious threats.
Two days before Thanksgiving, Heidi Mosier took her infant son Brauhner to the emergency room closest to her home in Taft, worried by his severe diarrhea. She waited 11 hours for someone at Mercy Hospital of Bakersfield to see her son, who grew increasingly dehydrated and pale. The hospital has not had any licensed pediatric beds since 2002.
When doctors finally examined Brauhner, Mosier said they seemed unaccustomed to treating infants and had difficulty inserting an IV.
"They had to try every part on him -- arms, legs, ankles, feet, everywhere -- until they got one," she said.
Doctors at Mercy transferred Brauhner to Memorial Hospital in Bakersfield. An emergency room doctor there immediately put him in an ambulance that raced up Highway 99 to Children's Hospital Central California, where he was diagnosed with a highly treatable milk allergy.
Brauhner was admitted to the 338-bed facility, about 150 miles from home. Mosier was fortunate that her mother had an RV to lend, making it possible for family to be nearby during the 11-day hospital stay.
In recent years, pediatricians nationwide have been providing anecdotal reports of pediatric bed closures and the ramifications, but researchers are only just beginning to study the phenomenon. The American Academy of Pediatrics, in an unpublished study, determined that pediatric bed losses are proportionally much greater than those for adult patients.
Hardest hit have been rural, non-teaching hospitals, which lost about 80% of their ped- iatric beds between 1992 and 2004, according to Dr. Ted Sigrest, who serves on the academy's committee studying the trend.
"Small, rural, non-teaching hospitals really only rarely have pediatric beds now," Sigrest said. "A lot of the kids are being admitted to the larger teaching hospitals, and parents are traveling farther to have their kids admitted."
As a result, Sigrest said, 65% of the larger teaching hospitals reported overcrowding and a majority reported delays in admission.
Even with cutbacks in care, competition for pediatric specialists is fierce. Children's Hospital Central California has been trying to hire a pediatric surgeon for two years, said chief executive William Haug. He estimates that there may be 75 to 100 openings nationwide, with only about a dozen available surgeons.
In California, researchers at the UCLA Center for Health Policy Research are expected to release a report in the next few months finding that staffed pediatric beds are not keeping pace with population, leaving hospitals scrambling for open beds and in some instances treating children as outpatients when admitting them would be preferable.
Currently, the state has about one licensed pediatric bed per 2,500 children. But UCLA researcher Dylan Roby said that although it seems clear that pediatric care is strained, no one really knows how many beds are needed because the issue has not been adequately studied.
Much of the burden for caring for sick children now falls on the state's eight regional children's hospitals -- where caring for patients has become a complex and costly shuffle. At times, children are turned away for lack of room.
Childrens Hospital Los Angeles, which has 286 pediatric beds, diverted ambulances from its emergency room for 328 hours in 2008.
"We get a number of calls from community hospitals and we say, 'Sorry, we're full,' " said Richard Cordova, the hospital's president and chief executive. "We may have four or five patients in the emergency room waiting for admission and four or five scheduled for surgery tomorrow."
And even though more children are being treated in outpatient clinics, Cordova said, "the waiting time for the next appointment gets longer and longer and longer."
Locally, hospitals that still serve children are bracing for ripple effects of the latest losses.
Los Angeles County-USC Medical Center recently moved into its new building with 36 beds specifically for pediatric patients. An additional 19 are available for pediatric use but can also be used for adults. Before the November move, the facility had 74 inpatient beds for children, already a steep drop from the 135 licensed pediatric beds there in 2006.
Pediatricians on the front lines said the drawdown would be acutely felt throughout Los Angeles County. Aside from the county's dedicated children's hospital, only four others provide a full array of pediatric subspecialty care: Miller Children's Hospital in Long Beach, UCLA Medical Center in Westwood, Harbor-UCLA Medical Center in Torrance and County-USC.
"In my 30 years here, this is the biggest hit we have ever sustained," said Dr. Lawrence Opas, County-USC's chief of pediatrics and director of graduate medical education at USC's Keck School of Medicine.
"I don't see how this will not be harmful."
kimi.yoshino@latimes.com
By Kimi Yoshino January 25, 2009
Within two hours of Roman Rodriguez's birth in Fontana, ambulances rushed him to Childrens Hospital Los Angeles, 50 miles away. State-of-the-art equipment kept the newborn alive as doctors performed five surgeries to repair intestines that had wiggled through a hole in his diaphragm and landed on his right lung.
Roman -- who had spent every day of his young life at the hospital in Hollywood -- was still on oxygen, with more surgery possible, when doctors told his mother in early December that it was time for the 6-week-old infant to leave. They needed his bed for a sicker child. He was transferred to a nearby hospital that dedicates far fewer resources to pediatric care.
"Now it's like he has to start all over again, which is very difficult for us and for him," his mother, Crystal Carmen, said at the time.
Three weeks ago, after five more surgeries, Roman moved yet again, this time back to the hospital in Fontana where he was born.
"It's nicer," Carmen said of the shorter commute. "We just feel that if he [had stayed] at Childrens, he would be home already."
This is the juggling act of pediatric care in California, where parents and medical professionals are grappling with a significantly diminished network of care for the state's 10 million children.
In the last decade, even as the number of children has grown, more than 65 hospitals have either eliminated their children's units or shut down altogether. More than two dozen others have reduced the number of beds for children. Most counties north of Sacramento now lack even a single dedicated pediatric bed.
In all, more than 800 inpatient children's beds were lost from 1998 through 2007 -- a 19% drop, a Times analysis found. More than half of those losses have been in Los Angeles County, where dozens more pediatric beds have been eliminated since. The analysis did not look at intensive care beds for children and infants.
Concentrating children's services at specialized centers can sometimes provide better care. Sick children are not equivalent to smaller-scale adults. Their treatment requires particular training and equipment. But the widespread loss of pediatric beds appears to be driven more by financial pressure than any shift in medical protocol or practice.
Policy experts, nurses and many pediatricians worry that young patients are now concentrated at too few hospitals, even with more children being treated as outpatients.
Hospitals have cut back on services for children without serious, coordinated analysis of how the losses statewide could affect the quality of care, particularly with many regions expecting a population increase. With the economic downturn forcing even more hospitals to the brink of closure, the condition of the children's healthcare system in the state reflects the ad hoc manner in which many decisions affecting life and death are made, according to healthcare experts.
"In California, things are a mess," said pediatrician Paul Wise, a children's health policy researcher at Stanford. "There seems to be a lack of any coherent monitoring or oversight."
Faced with shrinking budgets, many California hospitals have been forced to shift resources toward adults, who receive higher state and federal subsidies. To make matters worse, California's Medi-Cal reimbursement rates for children's healthcare ranks last in the country, said Diana Dooley, chief executive of the California Children's Hospital Assn.
"Some children will be denied the level of care that they need," Dooley said. "They'll have to get no care or they'll have to get care that isn't delivered by . . . pediatricians trained in the special needs of children."
In November, voters approved a $980-million children's hospital bond, which will help pay for construction projects underway or planned. But even that cash infusion won't make up for the beds already lost in what Wise calls an evaporation of pediatric care.
In the Central Valley, hospital closures and population growth have strained Children's Hospital Central California. Serving 10 counties and 45,000 square miles, officials there have set aside six RV parking spaces for patients' families and allow them to tap the hospital's power supply.
In some cases, lack of nearby pediatric care turns relatively simple medical issues into more serious threats.
Two days before Thanksgiving, Heidi Mosier took her infant son Brauhner to the emergency room closest to her home in Taft, worried by his severe diarrhea. She waited 11 hours for someone at Mercy Hospital of Bakersfield to see her son, who grew increasingly dehydrated and pale. The hospital has not had any licensed pediatric beds since 2002.
When doctors finally examined Brauhner, Mosier said they seemed unaccustomed to treating infants and had difficulty inserting an IV.
"They had to try every part on him -- arms, legs, ankles, feet, everywhere -- until they got one," she said.
Doctors at Mercy transferred Brauhner to Memorial Hospital in Bakersfield. An emergency room doctor there immediately put him in an ambulance that raced up Highway 99 to Children's Hospital Central California, where he was diagnosed with a highly treatable milk allergy.
Brauhner was admitted to the 338-bed facility, about 150 miles from home. Mosier was fortunate that her mother had an RV to lend, making it possible for family to be nearby during the 11-day hospital stay.
In recent years, pediatricians nationwide have been providing anecdotal reports of pediatric bed closures and the ramifications, but researchers are only just beginning to study the phenomenon. The American Academy of Pediatrics, in an unpublished study, determined that pediatric bed losses are proportionally much greater than those for adult patients.
Hardest hit have been rural, non-teaching hospitals, which lost about 80% of their ped- iatric beds between 1992 and 2004, according to Dr. Ted Sigrest, who serves on the academy's committee studying the trend.
"Small, rural, non-teaching hospitals really only rarely have pediatric beds now," Sigrest said. "A lot of the kids are being admitted to the larger teaching hospitals, and parents are traveling farther to have their kids admitted."
As a result, Sigrest said, 65% of the larger teaching hospitals reported overcrowding and a majority reported delays in admission.
Even with cutbacks in care, competition for pediatric specialists is fierce. Children's Hospital Central California has been trying to hire a pediatric surgeon for two years, said chief executive William Haug. He estimates that there may be 75 to 100 openings nationwide, with only about a dozen available surgeons.
In California, researchers at the UCLA Center for Health Policy Research are expected to release a report in the next few months finding that staffed pediatric beds are not keeping pace with population, leaving hospitals scrambling for open beds and in some instances treating children as outpatients when admitting them would be preferable.
Currently, the state has about one licensed pediatric bed per 2,500 children. But UCLA researcher Dylan Roby said that although it seems clear that pediatric care is strained, no one really knows how many beds are needed because the issue has not been adequately studied.
Much of the burden for caring for sick children now falls on the state's eight regional children's hospitals -- where caring for patients has become a complex and costly shuffle. At times, children are turned away for lack of room.
Childrens Hospital Los Angeles, which has 286 pediatric beds, diverted ambulances from its emergency room for 328 hours in 2008.
"We get a number of calls from community hospitals and we say, 'Sorry, we're full,' " said Richard Cordova, the hospital's president and chief executive. "We may have four or five patients in the emergency room waiting for admission and four or five scheduled for surgery tomorrow."
And even though more children are being treated in outpatient clinics, Cordova said, "the waiting time for the next appointment gets longer and longer and longer."
Locally, hospitals that still serve children are bracing for ripple effects of the latest losses.
Los Angeles County-USC Medical Center recently moved into its new building with 36 beds specifically for pediatric patients. An additional 19 are available for pediatric use but can also be used for adults. Before the November move, the facility had 74 inpatient beds for children, already a steep drop from the 135 licensed pediatric beds there in 2006.
Pediatricians on the front lines said the drawdown would be acutely felt throughout Los Angeles County. Aside from the county's dedicated children's hospital, only four others provide a full array of pediatric subspecialty care: Miller Children's Hospital in Long Beach, UCLA Medical Center in Westwood, Harbor-UCLA Medical Center in Torrance and County-USC.
"In my 30 years here, this is the biggest hit we have ever sustained," said Dr. Lawrence Opas, County-USC's chief of pediatrics and director of graduate medical education at USC's Keck School of Medicine.
"I don't see how this will not be harmful."
kimi.yoshino@latimes.com
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