Gap Seen in Readmit Rates by Race, Location

By Michael Smith, North American Correspondent, MedPage Today

Older black patients admitted to hospital for three common conditions -- congestive heart failure, heart attack, or pneumonia -- are 13% more likely than whites to be readmitted within a month, researchers reported.

But the analysis of Medicare discharge data for more than three million patients, also found disparities related to where patients get care -- both blacks and whites treated at hospitals with a large proportion of black patients had even higher readmission rates, according to Karen Joynt, MD, PhD, of Brigham and Women's Hospital in Boston, and colleagues.

Overall, about one in five older patients admitted to the hospital with heart failure, MI, or pneumonia were readmitted within 30 days, Joynt and co-authors wrote in the Feb. 16 issue of the Journal of the American Medical Association.

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QuickStats: Death Rates* For Persons Aged ≥65 Years, with Diabetes as the Underlying or a Contributing Cause, by Race and Sex --- United States, 1981--2007

* Rates are age-adjusted per 100,000 U.S. standard population aged ≥65 years. Cause of death is based on International Classification of Diseases, Ninth Revision (ICD-9) code 250 (Diabetes mellitus) for 1981--1998 and International Classification of Diseases, 10th Revision (ICD-10) codes E10--E14 (Diabetes mellitus) for 1999--2007.

Diabetes is a leading cause of death in the United States and a contributing cause of deaths from many other conditions. In 2007, diabetes was a contributing cause of death 2.4 times as often as it was the underlying cause of death for persons aged ≥65 years. Age-adjusted death rates for deaths with diabetes declined for white and black persons aged ≥65 years from 2005 to 2007, after generally increasing from 1981 to 2002. In 2007, the rate was higher for black men and women than for white men and women.

Sources: 

CDC. National Vital Statistics System. Available at http://www.cdc.gov/nchs/nvss.htm.

CDC. Health Data Interactive. Available at http://www.cdc.gov/nchs/hdi.htm.

 

CLAS Standard Public Comment

The US Department of Health and Human Services’ Office of Minority Health is seeking public input from individuals and professional communities across the country for the CLAS (Culturally and Linguistically Appropriate Services) Standards Enhancement Initiative.  This initiative is an effort to make enhancements to the National Standards for CLAS in Health Care, first released in 2000.  The goal of the enhancement process is to maximize access in gathering public input and stakeholder dialogue to ensure that the CLAS Standards serve the health needs of everyone. 

To submit your comments electronically or attend a public comment session, go to: https://clasenhancements.thinkculturalhealth.org/. 

To access a copy of the CLAS Standards, go to: http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=15

For more information, please contact Leslie Swann at Leslie.Swann@aoa.hhs.gov or 202-357-3453.   

Off the Charts Blog | Center on Budget and Policy Priorities | Countdown Day 4: Top Ten Facts About Social Security

by Kathy Ruffing

Social Security is particularly important for African Americans and Hispanics. A person’s race and ethnicity do not affect his or her Social Security eligibility or benefit levels. However, Social Security is a particularly important source of income for groups with low earnings and with less opportunity to save and earn pensions, including African Americans and Hispanics.

Among beneficiaries aged 65 and older, Social Security represents 90 percent or more of income for:

• 25 percent of Caucasians,
• 34 percent of African Americans, and
• 33 percent of Hispanics.

As we mentioned earlier, Social Security is more than just a retirement program, and its disability and survivor protections are very important to minorities.

Social Security is especially beneficial for women. Because women tend to earn less than men, take more time out of the paid workforce, live longer, accumulate less savings, and receive smaller pensions, Social Security is especially important for them. Women pay 40 percent of Social Security payroll taxes but receive 49 percent of benefits. They benefit disproportionately from the program’s inflation-protected benefits (because women tend to live longer than men), its progressive formula for computing benefits (because they tend to have lower earnings), and its benefits for spouses and survivors.

Off the Charts Blog | Center on Budget and Policy Priorities | Blog Archive | Countdown Day 4: Top Ten Facts About Social Security

New York City Council Cuts Health Ombudsman Program - NYTimes.com

By ANEMONA HARTOCOLLIS

A program that for a decade helped New York City’s poor and elderly navigate their way through insurance problems — and that became a model for a similar federal program — has become a casualty of city budget cuts, an administrator of the program said on Thursday.

The $4 million program sent ombudsmen to 25 social service agencies across the city, including the Legal Aid Society and agencies serving Latino, Asian, Polish and Jewish communities across the city.
Those ombudsmen were trained to help people obtain insurance, get health services and contest claims that had been denied by insurance companies and hospitals. The program helped about 10,000 people a year, said David R. Jones, president of the Community Service Society, which administered it.

New York City Council Cuts Health Ombudsman Program - NYTimes.com

Arthritis More Disabling for Minority Patients from MedPage Today

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By Crystal Phend, Senior Staff Writer, MedPage Today

Arthritis causes more disability in minorities despite lower arthritis prevalence than in whites, according to results of a nationally representative survey.

Black and Hispanic patients reported more pain and restriction of daily activities with arthritis than did white patients, Julie Bolen, PhD, of the CDC in Atlanta, and colleagues reported in the May issue of Preventing Chronic Disease.

These findings point to the need for culturally appropriate and effective intervention tailored to these populations, they wrote.
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Special Needs of Older Minorities

No provider of long-term services and supports can ignore the growing diversity of the aging population. For example, one in every five people aged 50 to 69 in the United States will be of Hispanic origin in 2030 [1] and the number of elderly immigrants will quadruple by 2050. [2] The number of Hispanic nursing home residents has been rising steadily since 2000 because older Hispanics have fewer family members available to care for them at home. [3]

As these trends continue, providers of long-term services and supports will feel pressure to tailor their services to an increasingly diverse clientele. This will mean serving native foods and hiring staff who speak native tongues. But it will also mean helping minority elderly meet the often pressing economic and health care needs that follow them into old age.

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Urban Institute: Estimating the Cost of Racial and Ethnic Health Disparities

This analysis estimates cost burdens of racial and ethnic disparities in a select set of preventable diseases including diabetes, hypertension and stroke. Excess rates of these diseases among African Americans and Latinos relative to whites will cost the health care system $23.9 billion dollars in 2009. Medicare alone will spend an extra $15.6 billion, and private insurers will spend an extra $5.1 billion. Over the next decade, the total cost is approximately $337 billion. Left unchecked, these annual costs will more than double by 2050 as the representation of Latinos and African Americans among the elderly increases.

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Race Plays Role In Diagnosis And Treatment - Kaiser Health News

CNN reports that African Americans and whites are treated differently by doctors. "While it's extremely difficult to tell in any given situation how much race -- consciously or unconsciously -- plays a role in a doctor's decision making, multiple studies over several decades have found doctors make different decisions for black patients and white patients even when they have the same medical problems and the same insurance." For example, "In a study conducted in 2007, Harvard researchers showed doctors a vignette about a 50-year-old man with chest pain who arrived at the emergency room, where an EKG showed he'd had a heart attack. Sometimes the researchers paired the medical history with a photo of black man and other times with a photo of a white man. The doctors were significantly more likely to recommend lifesaving drugs when they thought the patient was white than when they thought the patient was black" (Cohen, 7/23). In other news, "recently released statistics from the Centers for Disease Control and Prevention (CDC) show that minority groups experience obesity at even greater levels than their white counterparts," The Milwaukee Health Examiner/Examiner reports. "According to the July 17 issue of the Morbidity and Mortality Weekly Report, blacks have a 51 percent greater prevalence of obesity than whites. Hispanics also experience a greater percentage of obesity than whites with a 21 percent higher prevalence, according to the CDC publication." Read More

Cooperative Agreements for "Heir Propoerty"

The Rural Business-Cooperative Service (RBS) announces the availability of approximately $230,000 in funds for fiscal year (FY) 2009 for cooperative agreements to develop and implement pilot programs aimed at: (1) Preventing and alleviating the problems facing African Americans in rural areas that are involved with real estate with clouded title due to unresolved interests of generations of heirs (otherwise known as ``heir properties''); (2) establishing an outreach/educational program that will assist farmers and homeowners with heir property issues in expanding ownership; and (3) enabling farming heir property owners to develop economically viable agricultural operations and accrue homeownership. DATES: Please submit proposals and applications for the initial cooperative agreements no later than 30 days from the date of publication (12/05/2008) in the Federal Register. Late applications will not be eligible for FY 2009 funding.

A Butler Well Served by This Election

By Wil HaygoodWashington Post Staff Writer Friday, November 7, 2008 For more than three decades Eugene Allen worked in the White House, a black man unknown to the headlines. During some of those years, harsh segregation laws lay upon the land. He saw eight presidential administrations come and go, often working six days a week. He was there while America's racial history was being remade: Brown v. Board of Education, the Little Rock school crisis, the 1963 March on Washington, the cities burning, the civil rights bills, the assassinations. When he started at the White House in 1952, he couldn't even use the public restrooms when he ventured back to his native Virginia. "We had never had anything," Allen, 89, recalls of black America at the time. "I was always hoping things would get better." In its long history, the White House -- just note the name -- has had a complex and vexing relationship with black Americans.

Alaska Native Areas (ANAs) Program for the 2010 Census

The Bureau of the Census (Census Bureau) is providing notification of final criteria and guidelines for Alaska Native Areas (ANAs) for the 2010 Census.

ANAs are geographic entities within the state of Alaska defined for the collection, tabulation, and presentation of decennial census data and will be used for the 2010 Census. ANAs also will be used to tabulate and present period estimates from the American Community Survey (ACS) after 2010 and potentially other Census Bureau statistical data. ANAs consist of two types of unique geographic entities: Alaska Native Regional Corporations (ANRCs) and Alaska Native village statistical areas (ANVSAs).

National American Indian Heritage Month, 2008

NOW, THEREFORE, I, GEORGE W. BUSH, President of the United States of America, by virtue of the authority vested in me by the Constitution and laws of the United States, do hereby proclaim November 2008 as National American Indian Heritage Month. I call upon all Americans to commemorate this month with appropriate programs and activities.

Complementary and Alternative Medicine Use Among Older African-Americans

Older African Americans may be vulnerable to risks due to impaired healthcare access and understudied complementary and alternative medicine (CAM) use and other traditions. This study describes CAM use among older African Americans in Baltimore, MD, examining associations among CAM and sociodemographic, health status, healthcare utilization and neighborhood factors. Complementary and Alternative Medicine Use among Older Urban African Americans: Individual and Neighborhood Associations JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION VOL. 100, NO. 10, OCTOBER 2008 Priscilla T . R yder, PhD; B everly Wolpert, MS; Denise Orwig, PhD; Olivia C arter-Pokras, PhD; Sandra A. B lack, PhD

HR 6897 Filipino Veterans Equity Act of 2008

To authorize the Secretary of Veterans Affairs to make certain payments to eligible persons who served in the Philippines during World War II. September 15, 2008 - Introduced and referred to House Committee on Veterans' Affairs.

Health Implications of Targeted Food and Beverage Marketing to African Americans

September 2008, Vol 98, No. 9 American Journal of Public Health 1616-1629 Targeted marketing of high-calorie foods and beverages to ethnic minority populations, relative to more healthful foods, may contribute to ethnic disparities in obesity and other diet-related chronic conditions.

Blacks with Breathing Conditions Have Higher Risk for Lung Cancer

from the Kaiser Health Disparities Report: A Weekly Look At Race, Ethnicity And Health Blacks with chronic obstructive pulmonary disease -- including chronic bronchitis and some types of serious chronic asthma -- have a risk for developing lung cancer about twice as high as that of whites with the condition, according to a study published in the journal Cancer Prevention Research, Reuters reports. For the study, lead researcher Carol Etzel of the University of Texas M.D. Anderson Cancer Center and colleagues developed a risk assessment model to help predict blacks' risk for lung cancer. Researchers analyzed data on 491 blacks with lung cancer and 497 blacks without the disease to develop the tool and then compared it with the existing risk models for whites. Researchers said that blacks' high risk for COPD prompted them to develop the risk assessment model to help doctors better predict lung cancer risk. The new model found that black men with a history of COPD had a more than sixfold increased risk of developing lung cancer, which is about the same risk for those who smoke. According to Reuters, both black and white smokers have a risk of lung cancer six times higher than that of non-smokers. Smoking is the leading cause of COPD, but pollution, and other environmental factors also play a role, Reuters reports. Etzel said, "What we hope is that a doctor can use these models to encourage their patients to take steps to prevent lung cancer. Even if they are never smokers, they can be at risk." The researchers now are working on a risk model for Hispanics (Reuters, 9/4). Study Report is available online: Development and Validation of a Lung Cancer Risk Prediction Model for African-Americans

Trends in U.S. Public Awareness of Racial and Ethnic Health Disparities

The proposed survey seeks to collect data for one of OMH's annual performance measures, approved by OMB in February 2007, following Office of Management and Budget (OMB)'s examination of OMH using the Program Assessment Rating Tool (PART). This measure is to ``increase awareness of[[Page 49675]]racial/ethnic health status and health care disparities in the general population.'' Findings from this data collection will enable OMH to track progress on this measure over time as mandated by OMB PART requirements. The lack of general awareness and understanding about the nature and extent of racial and ethnic health disparities in the U.S. and the impact that such disparities are having on the overall health of the Nation have been cited as a major barrier to the provision of programmatic, budgetary, and policy attention to these issues. Therefore, one of the long-term, annual measures agreed upon was to ``increase awareness of racial/ethnic health status and health care disparities in the general population.''

Older Hispanics find health care lacking

Arelis Hernandez Orlanda Sentinel Staff Writer - August 8, 2008 Florida is facing an explosion in its number of elderly Hispanic residents, raising concerns about the strain on a health-care system little prepared to handle their unique needs. In 1995, U.S. census officials said Florida would face a 102 percent increase in Hispanics age 65 and older by 2010, from about 237,000 to 480,000. By 2007, the Hispanic elderly population had already increased by 124 percent to 530,000 people, or 12.5 percent of the senior population, according to Department of Elder Affairs data.

Free Summit on Health Disparities Slated for December

The National Center on Minority Health and Health Disparities will be sponsoring a free summit, The Science of Eliminating Health Disparities, from December 16-18, 2008. The event will take place at the Gaylord National Resort & Convention Center. The conference will give attendees the chance to highlight the research progress of the NIH on health issues among racial/ethnic minority and medically underserved populations; increase awareness and understanding of disparities in health; showcase best-practice models in research, capacity-building, outreach, and integrated strategies to eliminate health disparities; identify strengths and gaps in health disparities research; and network and dialog with the nation’s leading experts on minority health and health disparities. Interested parties can register online at http://www.ncmhd.nih.gov.