TAG: "Health disparities"

Act of courage: Life after the ‘die-in’


UCSF med students sparked a national movement with #whitecoats4blacklives; what’s next?

UC San Francisco professional students led a national movement via social media that examined how racial disparities impact health care. (Photo by Leland Kim, UC San Francisco)

By Leland Kim and Laura Kurtzman, UC San Francisco

A group of UCSF medical students gathered in a closed meeting last month to talk about race, racism and racial disparities.

They were troubled by recent grand jury decisions not to indict white police officers who were involved in the deaths of two unarmed African American men, Michael Brown in Ferguson, Mo., and Eric Garner in New York City, and wanted to channel their frustration into something constructive.

The students, including many from the UCSF Underrepresented In Medicine (UIM) mentoring program, decided to hold a “die-in” at UCSF while wearing their white coats, symbolic of those in the health profession. They and their peers of all ethnic backgrounds tapped into student networks across the country.

In just five days, a national movement called #whitecoats4blacklives was born.

It catalyzed thousands of students, faculty and staff in more than 80 colleges across the country. At UCSF, students from all professional schools (dentistry, medicine, nursing and pharmacy) and the Graduate Division participated, as well as some faculty and staff members.

The hashtag dominated social media on Dec. 10, garnering widespread media attention and sparking a much-needed national conversation about racism being more than a just criminal justice issue.

Organizers of the student #whitecoats4blacklives die-in were invited to participate in the School of Medicine leadership retreat to share their experiences. (From left) Frederick Jamison, Angela Broad, Faby Molina, Adali Martinez, Donald Richards, Stephen Villa, Sidra Bonner and Nicolás Barceló. (Photo by Elisabeth Fall)

“As students, we were able to use the momentum from the #whitecoats4blacklives movement to demonstrate the urgency of dealing with the issues of race, micro-aggressions and inequality that affects UCSF faculty, staff, students and most importantly the patients we all serve,” said student organizer Sidra Bonner, a second-year student in the School of Medicine. “It is my hope that this movement leads to improvement of the social medicine curriculum, specifically continued learning and skill development around this issue of bias, creation of a robust mentorship/advising system for all students, as well as commitment to strengthening the pipeline for underrepresented students in medicine by increased availability of scholarships and administrative support.”

A priority for the university

The die-in had a ripple effect across UCSF.

A student-initiated town hall held two days after attracted faculty members, deans and many of the University’s top leaders, who talked openly with students about the UCSF’s ongoing challenge with diversity.

Chancellor Sam Hawgood, M.B.B.S., has made race and racial inequities a priority in his administration.

“This is an issue that goes beyond any one school or department; this is a campus issue,” he said. “Diversity is going to be an important priority for the entire UCSF community. I thank our students for initiating this conversation.”

And organizers of the School of Medicine’s annual leadership retreat this month decided to change the event’s agenda to discuss the enduring question of race in America – and how racial dynamics play out at UCSF.

“Our students are asking us to acknowledge, to think and to do something about the problem of racial and ethnic injustices,” said Bruce Wintroub, M.D., interim dean of the School of Medicine, introducing a daylong colloquy that was rich in both data and personal stories about what it means to be black and brown in America.

“It is very easy to talk about racial disparities at other places,” he said. “It is much harder for us to take an honest look at the problems we have at UCSF.”

Groundbreaking discussion of race

The leadership retreat, which took place on Jan. 8 and 9, was the first one ever to focus solely on race/ethnicity and health disparities. It came as the School of Medicine has launched a six-year, $9.6 million effort to hold its departments accountable for achieving diversity, provide the resources to recruit and retain a more diverse faculty, create a culture of diversity and inclusion and expand the pool of scientific talent, which gets smaller at each level of training.

“This retreat was the first time in my 32 years at UCSF that I feel we have started to have an authentic conversation about race and the impact of racism and unconscious bias on our students, faculty and patients,” said Renee Navarro, M.D., Pharm.D., vice chancellor of diversity and outreach. “I applaud the students who organized and implemented the #whitecoats4blacklives movement. They were the spark that led to this event.”

Some of those students were invited to participate in the leadership retreat and share their experiences with the group to help facilitate organizational change.

At times, nervous energy was palpable as students recalled instances of racism on campus. Some community members, participants noted, have accused UCSF being an “elitist ivory tower.”

White faculty members listened attentively, and some were candid enough to admit that they hadn’t really thought about racism and its impact on students and patients in a meaningful way.

“Being on the panel and speaking to an audience of accomplished and powerful people at UCSF were terrifying,” said Angela Broad, a second-year medical student. “It was really difficult sharing those experiences but the informal conversations I had throughout the day were very heartening. So many faculty, deans and staff thanked me for sharing my story.”

Compelling presentations and anecdotes by faculty of color helped shape the day’s conversation.

Neal Powe, M.D., M.P.H., M.B.A., vice chair of the Department of Medicine and chief of medical services at San Francisco General Hospital and Trauma Center, shared a story about being pulled over by the police in North Carolina while in town to give a lecture. A police officer suspiciously questioned Powe about his destination, instructed him to keep his hands on the steering wheel and asked him if he had drugs in the car.

Guest speaker Denise Rodgers, M.D., focused on the impact of race and racism on health and health care in her talk, helping the audience to understand how a climate of violence affects their patients and their health.

“When we teach about homicide, do we reinforce the stereotype of violent, lawless black men who should be feared and for whom there is little hope for change?” asked Rodgers, vice chancellor of Rutgers Biomedical and Health Sciences. “When we teach about homicide, do we talk about poverty, unemployment, poorly-performing schools, inadequate access to social and mental health services as contributors to the homicide rates we see?”

Nurturing a pipeline of UCSF talent

This year, one-third of first-year medical students are underserved minorities (black, Latino, Native American or Pacific Islander), the highest percentage of any medical school in California.

Despite having one of the most diverse student populations in the nation, a recent survey found that nearly one-third of students who are black, Latino and Native American reported feeling shunned or ignored or having experienced behavior they found intimidating, offensive or hostile, and 21 percent said it interfered with their ability to learn. That was double the percentage reported by whites and a third higher than reported by Asians.

Talmadge King, M.D., chair of the Department of Medicine, said the medical school is doing well at recruiting students, but many are not staying for their residency training.

Retention drops more at the fellowship training level and then essentially stops at the faculty level. Similar statistics also apply to the other professional schools and the Graduate Division.

King believes the best long-term strategy is for UCSF to build its own pipeline of talent, beginning with middle and high school, so students learn to love science and have an association to UCSF. “Places that have really focused on that are beginning to have success,” he said. ”It takes a long time, but it actually works.”

Turning words into action

UCSF leadership will review and evaluate ideas that were generated by the retreat participants and determine the priorities and tactics to move them forward. This effort is aligned with the campus obligation to the University of California Office of the President to identify initiatives in the UC-wide Climate Survey. Those initiatives will include one that is focused on establishing a “climate of inclusion.”

Meanwhile, the students who organized the #whitecoats4blacklives event have formalized the creation of the national White Coats for Black Lives organization that was born out of the movement. They are connected with 83 representatives of various medical schools throughout the country and are in the process of creating a national board for their student organization.

They will also be actively involved in working with faculty and leadership to achieve the goals identified during the leadership retreat.

“I have never felt so inspired by UCSF – what it is and what it can be,” said student organizer Nicolás Barceló, a fourth-year medical student who attended the retreat. “My decision to attend UCSF was motivated by the belief that its capacity to effectively address the social determinants of health, it stands alone. No other institution can bring together the resources, talent and dedication to social justice that you see at UCSF. No one.”

View original article

CATEGORY: SpotlightComments Off

Kids of melanoma survivors need better protection from sun’s harmful rays


UCLA study is first to include Latinos, whom have often been left out of skin cancer prevention research.

Credit: Sean Brenner, UCLA

By Reggie Kumar, UCLA

UCLA researchers have found that children of melanoma survivors are not comprehensively adhering to sun protection recommendations, despite them being at an increased risk for developing the disease as adults.

In the study led by Beth Glenn, associate director of the UCLA Jonsson Comprehensive Cancer Center’s Healthy and At-Risk Populations Research Program, researchers asked parents about their attitudes toward melanoma prevention, how at risk for melanoma they believed their child to be, and their current use of sun protection strategies for their child. They found that about three-quarters of parents relied on sunscreen to protect their child against sun exposure, but less than a third of parents reported that their child wore a hat or sunglasses or attempted to seek shade when exposed to the sun.

Additionally, Glenn said, 43 percent of parents surveyed reported that their child experienced a sunburn in the past year. This is concerning because sunburns are a major risk factor for melanoma.

The UCLA researchers used the California Cancer Registry (which tracks all cases of cancer across the state) to identify and survey 300 melanoma survivors with children ages 17 and younger during a three-year period. The study targeted both non-Latino white melanoma survivors and for the first time Latino melanoma survivors as well.

Latinos have often been left out of skin cancer prevention research due to a common misconception that sun protection is not important for this group.

“Sunburns were common among the children in our study despite their elevated risk for skin cancer. Also, children of Latino survivors were just as likely as children of non-Latino white survivors to have experienced a recent sunburn, which highlights the importance of including this group in our work,” said Glenn, associate professor of Health Policy and Management in the UCLA Fielding School of Public Health.

The survey results will be used to apply for additional funding to develop an intervention program that combines a text message reminder system with educational materials and activities for parents and children. The intervention program is designed to help melanoma survivors more effectively monitor and properly protect their child against UV radiation.

“Protecting kids against the sun’s harmful rays at an early age is vitally important. Our goal is to develop an intervention that will help parents protect their children today and help children develop sun safe habits that will reduce their risk for skin cancer in the future,” said Glenn.

The study will be published online Jan. 13 in the journal Cancer Epidemiology, Biomarkers & Prevention.

The research was supported in part by the National Cancer Institute.

View original article

CATEGORY: NewsComments Off

Trending: Full-time employment with no health benefits


In 2012, nearly half of uninsured Californians were in families with a full-time worker.

By Venetia Lai, UCLA

Almost half of the 6.9 million Californians who lacked insurance in 2012 were in a family with a full-time worker, according to a new report from the UCLA Center for Health Policy Research.

The State of Health Insurance in California report also found that the number of adult workers with job-based health insurance declined between 2009 and 2012. Full-time workers saw a drop of 2.9 percentage points to 63.6 percent and part-time workers dropped 2.2 points to 39.6 percent.

The report is based on data from the 2011-12 California Health Interview Survey, which is the nation’s largest state-based health survey and one of the largest health surveys in the United States. Because the data were collected just before full implementation of health care reform, the latest State of Health Insurance in California report will serve as a baseline to gauge the effects of the Affordable Care Act.

“Health care reform filled a huge and growing gap in job-based insurance,” said Shana Alex Charles, lead author of the study and director of the Health Insurance Program at the Center for Health Policy Research. “Sadly, health insurance is no longer a guarantee provided by many employers.”

Latinos still in the medical “shadows”

According to the report, Latinos had the lowest rate of job-based health coverage — 33.9 percent, compared to 63.3 percent of whites — and the highest rate of not having insurance, 28.4 percent.

Although nearly a third of low-income adult Latinos had Medi-Cal, 1 in 4 still lacked a usual source of care, the report noted, and 17.2 percent of adult Latinos covered by job-based insurance didn’t see a doctor in 2011-12, a much higher rate than either non-Latino whites or African Americans.

“This report shows us where we were, and it wasn’t a good place,” said Gerald Kominski, director of the Center for Health Policy Research and co-author of the study. “From here on out we can accurately measure how California’s health improves under reform.”

Young adults gain job-based coverage in ACA reform

In an early example of the benefits of health care reform, the study found that adults ages 19-26 were the only age group that gained health coverage from 2009 to 2012, with job-based coverage for them jumping to from 23.2 percent to 27.1 percent. That was an increase of 254,000 people. This age group also experienced the largest drop in the rate of people without insurance; this rate went from 28.9 percent in 2009 to 26 percent in 2012.

But for older adults, the percentage of those covered by job-based insurance plummeted. In the 40- to 54-year-old age group, more than half a million people  lost job-based coverage — a drop from 49 percent in 2009 to 45.4 in 2012.

“With job-based coverage shrinking year after year and nearly a third of California’s Latino community without health coverage, California was poised and ready for the implementation of the Affordable Care Act,” said Robert Ross, president and CEO of The California Endowment, which co-funded the report along with the California Wellness Foundation. “I’m confident we’ll see improvements in health coverage rates when the 2014 enrollment numbers are crunched.”

High-deductible plans create “underinsurance”

Among people with insurance, high deductibles played a big role in whether people put off having medical procedures. Californians with high-deductible plans that they purchased directly from an insurance company delayed or went without needed medical care at a rate double that of those without high-deductible plans, 16.1 percent versus 6.6 percent.

While the share of workers carrying individually purchased insurance is small — about 5 percent of full-time workers and 9.5 percent of part-time workers — the burden falls on many who are small business owners, according to the report.

“These data underscore the importance of Covered California’s Small Business Health Options Program,” said Judy Belk, president and CEO of the California Wellness Foundation. “It makes getting health insurance much more affordable for small businesses. People should not have to put their health at risk because insurance premiums are too high.”

Other findings include:

White, middle class and uninsured. Among whites with a family income higher than 400 percent of the federal poverty level (about $92,200 for a family of four in 2012), 1 in 4 went without insurance all or part of the year.

Public health insurance programs protect millions. One-fifth of Californians under age 65 in 2012 — 6.4 million people — were insured by Medi-Cal and the Healthy Families programs. That included nearly 2.6 million low-income children ages 0-11. This represented an 8-percentage-point jump from 2009 — the biggest increase of any age group — to 40.3 percent covered. This increase underscores the importance of public health insurance programs in maintaining the health of children. Nearly 70 percent of children covered by Medi-Cal are Latino.

With the release of the report, policy analysts and health advocates have a tool to measure the extent to which ACA reforms changed health access and health outcomes among the state’s residents in 2014.

“While the clear early success of the ACA in enrolling young adults in private coverage is promising, our data show that even the insured have delays in care, problems affording deductibles, and other access barriers that we hope will be addressed,” Charles said.

View original article

CATEGORY: NewsComments Off

UC students bring attention to impact of racial disparities in health care


Students stage “white coat die-ins” nationwide, including at UCSF, other UC medical schools.

UC San Francisco professional students led a national movement via social media that examined how racial disparities impact health care. (Photo by Leland Kim, UC San Francisco)

By Leland Kim, UC San Francisco

A group of UCSF School of Medicine students started a nationwide movement to bring attention to the impact of racial disparities in health care. They led more than 2,000 students in 80 medical schools across the country in a “white coat die-in” where they lay down in their white coats to protest recent grand jury decisions not to indict white police officers who killed Michael Brown and Eric Garner, unarmed African American men in Ferguson, Missouri, and New York City, respectively.

At UCSF, more than 150 students and some faculty and staff members gathered in front of the UCSF Parnassus Library at noon on Dec. 10. Making sure not to block the sidewalk or entrance to the library, they lay down for 45 minutes in silence. Many closed their eyes. Some held hands.

“As health professional students, we really want to emphasize the fact that what happens in the community bears relation to what happens in our work,” said event organizer Nicolás Barceló, a fourth-year student in UCSF School of Medicine. “The context in which our patients live contextualizes the type of care we need to provide.”

This movement started at UCSF several weeks before the “die-in” when a core group of students of color in the UCSF Underrepresented In Medicine (UIM) program, and their white allies within the School of Medicine, worked with established networks of the Student National Medical Association (SNMA), the Latino Medical Students Association (LMSA), and the PRIME Program of UC medical schools to raise awareness. Soon after the hashtag #whitecoat4blacklives was born.

“Using social media as the primary driver, and with the help of incredible individuals, many of whom we had never met, our idea became a shared cause,” said Barceló. “Students at UPenn were responsible for creating the national Facebook group. The national press release disseminated through Physicians for a National Health Program (PNHP), which was a product of the collaboration between students from UCSF, UPenn, Brown and Mt Sinai. The artwork of white coats becoming flying doves – perhaps most symbolic of the movement –was created by a student at UCSF.”

The School of Medicine-led event also included participation by students in the School of Dentistry, School of Nursing and School of Pharmacy. Students from other UC medical schools also participated at their locations. The hashtag #WhiteCoats4BlackLives generated close to 2,000 posts or mentions on Twitter, Facebook and Instagram on the day of the event, reaching more than one million people. It was covered by local and national media, including MSNBC, the Huffington Post and the San Francisco Chronicle.

“This movement is particularly important because in the end we’re here to advocate for our patients, to be the voice for those who are not heard,” said Daniela Brissett, a second-year School of Medicine student who helped organize the event. “Health care disparities for people of color are ever growing and we need to change that. It’s the responsibility of us, as well as our faculty and our deans. And it starts here, and it starts with the resources we need to provide for our patients.”

Some faculty members and members of the leadership team, including Renee Navarro, Pharm.D., M.D., vice chancellor of diversity and outreach, came out to support the students.

“It’s been an incredible catalyst to bring together students,” said Barceló . “We couldn’t be more grateful for the support we’ve received from our administration, from our Vice Chancellor Dr. Renee Navarro.”

“I am inspired by our students,” Navarro said. “I’m inspired by our collaboration, the solidarity across our schools, across our faculty, our students and our staff coming together on such a critically important issue, and recognizing as deliverers of health care, this is such an important component of what we do and we should have a voice in this.”

As a follow up, the student organizers of the “die-in” scheduled a town hall meeting on Dec. 12 at Cole Hall to share reflections on violence and racial bias in the community as well as in the health care system. They also brainstormed ideas for organized student response with several deans and some faculty members.

“We look forward to having productive conversations with leadership here at UCSF and other UC campuses to amend our curriculum, to increase diversity both in the students and in the faculty,” Barceló said. “Ultimately we want to improve relations between our institutions and the communities we serve.”

In the days following the “die-in,” several other college campuses in other parts of the country hosted town halls and open meetings to discuss and develop a plan for institutional change.

At the national level, student leaders of the movement are deciding how to proceed in effecting change. They hope to systematically reform the policies and practice of medicine to more adequately address racism and violence as major determinants to health.

View original article

CATEGORY: NewsComments Off

Cloudy water, even if it is safe, affects rural immigrants’ health


UC Davis researchers examine connection between water quality, childhood obesity.

Cloudy tap water may have a greater effect for California’s rural immigrants than merely leaving behind a bad taste, according to a new policy brief released by the Center for Poverty Research at the University of California, Davis.

Researchers looked at the connection between water quality and childhood obesity in two poor immigrant communities in California’s Central Valley — San Joaquin and Firebaugh. Poor-quality tap water, or even a perception that the water is bad, combined with environmental factors such as lack of access to healthy foods and nutrition education, likely contribute to health disparities in these communities, the study finds.

“If the tap water that comes out looks dirty or has a poor taste, they’re not going to have a lot more confidence in the drinking system here,” said Lucia Kaiser, a UC Cooperative Extension specialist in the Department of Nutrition at UC Davis and the study’s co-principal investigator. “The immigrant populations in these communities come from Mexico, where they may have experienced unsafe drinking water in rural areas,” she said.

Kaiser interviewed 27 mothers from these communities after giving a class on the health effects of sugar-sweetened beverages. Most of the women reported relying on purchased and, to a lesser extent, home-filtered water for drinking and cooking. Kaiser said that the additional cost represents an extra burden on these low-income families.

“In these communities, more than a third can’t afford to put enough food on their table, and now they have to buy drinking water, too. Every expense really matters,” said Kaiser.

Read more

For more health news, visit UC Health, subscribe by email or follow us on Flipboard.

CATEGORY: NewsComments Off

2 UCSF-led programs receive funding to tackle S.F. health issues


Hellman Foundation supports fruit and vegetable voucher program, kids’ oral health program.

A woman shops for fresh produce at UCSF Parnassus' farmers market.

By Leland Kim, UC San Francisco

Two UC San Francisco-sponsored programs beat out more than 80 others to win major funding to help advance meaningful solutions to local health issues in San Francisco.

The Hellman Foundation announced the award of the first Hellman Collaborative Change Initiative grants to the EatSF Fruit and Vegetable Voucher Program and the Children’s Oral Health Collaborative. Each program will receive $400,000 — coupled with strategic support from the Hellman Foundation — to strengthen their partnerships and support their efforts to improve lives in San Francisco.

The EatSF Fruit and Vegetable Voucher Program is creating a San Francisco where underserved communities can enjoy fresh fruits and vegetables from their local market.

Diets low in fresh fruits and vegetables are associated with obesity, diabetes, cardiovascular diseases and some cancers.  But many low-income families simply do not have access to these vitally important foods. By creating a citywide network where vouchers are redeemable at local vendors for fresh fruits and vegetables, EatSF is improving nutrition for San Franciscans most in need.

“In 2012, it is estimated that San Francisco’s underserved population had to scramble to afford 67.8 million meals. That is appalling in a city that is as wealthy as ours,” said Hilary Seligman, M.D., an associate professor in the UCSF School of Medicine, who is leading the EatSF Fruit and Vegetable Voucher Program. “We are committed to finding strategies that allow all members of our community to eat the healthy foods that prevent the development of chronic disease.”

The Children’s Oral Health Collaborative is committed to eradicating health disparities in childhood tooth decay, with the aim of making San Francisco cavity-free. The program is co-led by UCSF’s Lisa Chung, D.D.S., M.P.H., and San Francisco Department of Public Health’s Margaret Fisher, R.D.H.A.P.

Tooth decay is the most common chronic childhood disease. In San Francisco, emergency department visits for preventable dental problems are higher than that for asthma and diabetes combined, and untreated tooth decay is two to three times more common for children of color.

“Our success is due to many dedicated partners, some individuals who have spent much of their careers to combat tooth decay, a pervasive health problem that all too often goes unacknowledged and untreated in children,” said Chung, an associate professor in the UCSF School of Dentistry’s Department of Preventive and Restorative Dental Sciences.

“Our collaboration recently formed thanks to the coordination and strong support from UCSF SF HIP (San Francisco Health Improvement Partnership) and SF DPH (San Francisco Department of Public Health), and funding from the Metta Fund. We hope this support from Hellman will bring greater awareness to the problem, our work to address it, and more partners to join us in our efforts.”

In choosing from an impressive array of active collaborations, the Hellman Foundation focused on cross-sector partnerships that had strong leadership, targeted a significant San Francisco challenge, and had the potential to make a real difference.

To learn more about the EatSF Fruit and Vegetable Voucher, please email eatsfvoucher@gmail.com. To get more information about the Children’s Oral Health Collaborative, please read its strategic plan.

Established in 2011, the Hellman Foundation finds and supports the creative change-makers improving the lives and livelihoods for all who call the San Francisco Bay Area home. For more information, visit its website.

Editor’s note: Content from the Hellman Foundation was used in this story.

View original story

CATEGORY: NewsComments Off

Is life in America hazardous to immigrants’ health?


Over time, the health status of immigrant groups tends to decline.

By Dan Gordon, UCLA

America is a nation of immigrants drawn from all parts of the world by the promise of freedom and a good life. But a substantial body of evidence suggests that for the newly arrived, life in the United States can be hazardous to their well-being.

When they get here, immigrants are on average healthier than their native-born American counterparts. But the longer they stay, the worse they fare on measures such as heart disease, hypertension, diabetes and mental health.

Faculty at the UCLA Fielding School of Public Health are working on identifying factors contributing to the declining health status of immigrant groups that’s occurring over time and through the generations.

Part of it has to do with an unfamiliarity with U.S. society and its complicated health care system. Many immigrants lack health insurance. But Marjorie Kagawa-Singer, a professor at the Fielding School who focuses on the delivery of care that appropriately considers a patient’s culture, notes that it’s more than just cost.

“If someone is new to this country, doesn’t speak the language and has to learn to navigate our system, it’s like plopping us in the middle of Siberia and expecting us to figure out what we need,” she said.

For example, many immigrants across the educational and cultural spectrum hold beliefs about disease and how the body works that diverge from the biomedical model practiced in the U.S., Kagawa-Singer added, and many health care practitioners are uneducated on those differences.

“When you have problems in both health literacy among patients and cultural competence among practitioners, you get this ‘perfect storm’ of people who will not be able to utilize the health care system even when it’s offered,” said Kagawa-Singer.

Since 2000, Kagawa-Singer has headed the Los Angeles site of the Asian American Network for Cancer Awareness, Research and Training, the first federally funded cancer prevention and control research initiative focusing on Asian Americans. In lectures and short courses on cultural competence, Kagawa-Singer advises health professionals to demonstrate their trustworthiness and compassion.

“It’s not the health problem you’re treating, it’s the person,” she said. “When patients recognize you’re making the effort and respecting their dignity, they’re going to be much more forgiving and willing to teach and learn.” The challenge, she noted, is that the U.S. health care system is designed for short encounters, despite the fact that it may take longer to get to know and understand patients from different backgrounds.

Adopting the American diet

Public health experts have postulated that immigrants decline in health as they assimilate and adopt the health habits of their new communities — including high-fat diets and processed foods, along with reduced physical activity. To some extent, though, that equation has changed with globalization of the food supply, said May C. Wang, a Fielding School professor who focuses on early childhood obesity.

“Most low-income countries now have access to the processed foods we’ve been eating for the past few decades,” Wang noted. But even when immigrants’ tastes are similar to those of non-immigrants, immigrants with minimal financial means face considerable challenges to eating well. “Education alone doesn’t work in a community that doesn’t have the ability to access healthy food,” Wang said. “And in the very poorest communities, trying to change the environment by placing healthier foods where people live, work and go to school is challenging.”

The problem is compounded for immigrant groups, she explained, because they tend to have fewer social ties, are constricted by language barriers and often lack the know-how to pursue resources that could help them.

Wang works closely with the Public Health Foundation Enterprises Women, Infants, and Children (WIC) Program, the largest local WIC agency in the country. It serves 300,000-plus families a year, the vast majority of them non-English-speaking immigrants. The overall childhood obesity rate has plateaued or declined in the U.S. in recent years, Wang noted, but the obesity rate among the mostly immigrant Latino children remains substantially higher than for other groups. Among the low-income, preschool-aged Latino children enrolled in L.A. County’s WIC program in 2011, nearly 22 percent were obese.

To better understand the impact of various strategies to improve diet and reduce early childhood obesity, said Wang, “We are examining the social and physical environments in which immigrants live and how these affect their ability to put into practice nutrition knowledge they acquire from participation in the WIC program.”

The work aligns with the University of California Global Food Initiative, which seeks to harness the resources of all 10 UC campuses to address a critical issue of our time: How to sustainably and nutritiously feed a world population expected to reach eight billion by 2025.

Read more

For more health news, visit UC Health, subscribe by email or follow us on Flipboard.

CATEGORY: NewsComments Off

Perceptions, referrals by providers affect mental health treatment disparities


Asian-American patients least likely to be assessed or counseled for mental health problems.

Oanh Meyer, UC Davis

By Phyllis Brown, UC Davis

Disparities in mental health treatment are known to be associated with patients’ racial and ethnic backgrounds. Now, a large study by researchers with UC Davis has found one possible reason for those disparities: Some racial and ethnic minorities are less likely to be assessed and referred for treatment by their medical providers.

The study of more than 9,000 diverse individuals, including Latinos, African Americans, Asian Americans and non-Hispanic whites, found that patients of different racial and ethnic backgrounds reported experiencing differing treatment approaches from medical providers, such as primary care physicians and specialists, including referrals to mental health care and medications, and that these differences were associated with race.

The research, “Disparities in Assessment, Treatment, and Recommendations for Specialty Mental-Health Care: Patient Reports of Medical Provider Behavior,” is published online today (Dec. 1) in Health Services Research, a journal of the Health Research and Educational Trust of the American Hospital Association.

It found that when compared with non-Hispanic white patients, Asian-American patients were the least likely to be assessed or counseled for mental health or substance abuse problems, and also were less likely to receive recommendations for treatment with medication. These differences were resolved after factors such as education, income and clinical diagnosis were taken into account, said Oanh Meyer, a postdoctoral scholar in the UC Davis Department of Neurology.

“These findings are especially important for medical providers treating racial and ethnic minorities,” Meyer said. “Minorities are far more likely to seek treatment for their mental health problems from their primary care physicians. Since these providers are the source of referrals to mental health professionals, they serve as the gatekeepers.”

Read more

For more health news, visit UC Health, subscribe by email or follow us on Flipboard.

CATEGORY: NewsComments Off

Online tool provides health information by ZIP code, city, legislative district


UCLA site advances Center for Health Policy Research mission of democratizing data.

For the first time, anyone can easily access comprehensive California health statistics by ZIP code, city and legislative district thanks to a new web tool created by the UCLA Center for Health Policy Research. The easy-to-use AskCHIS Neighborhood Edition, or AskCHIS NE, enables users to customize searches, compare and “pool” small geographic areas, and map and chart their results.

AskCHIS NE covers a wide range of health topics, including rates of health insurance, chronic conditions like asthma and diabetes, and behaviors like smoking and physical activity; quality of children’s health; and access to health care and mental health care; and much more.

AskCHIS Neighborhood Edition is a service of the center’s renowned California Health Interview Survey, the nation’s largest state health survey. An existing companion web tool, AskCHIS, allows users to find health data at the county, region and state levels.

AskCHIS NE drills down even deeper than AskCHIS, allowing users to quickly find health disparities within specific cities or legislative districts. Using the system’s pooling feature, hospitals can build health profiles of their service areas, combining ZIP codes or cities. Community groups can decide which programs to offer at parks based on a neighborhood’s specific health needs. Journalists can compare obesity rates in neighborhoods they cover.

“This is the first time that Californians will be able to access neighborhood health information in just a few, simple steps,” said Ninez Ponce, the California Health Interview Survey’s principal investigator. “This information will help Californians make health decisions that are specifically targeted to the unique needs of their communities.”

Using AskCHIS NE is simple:

  • Log onto http://askchisne.ucla.edu. People who have previously used AskCHIS can use an existing logon ID and password; new users can create a free account before logging in for the first time.
  • Select a topic from the panel on the left.
  • Search for geographic areas of interest and click the “Create a table” button.
  • The search results are quickly displayed in a table, bar chart and interactive map.

The interactive map makes it easy to for users to see health disparities across the landscape. Data for one ZIP code can be loaded and displayed, but the user also can zoom out to view adjacent ZIP codes or the entire state for comparison.

As in AskCHIS, results can be easily exported into Excel spreadsheets. But AskCHIS NE also makes it easy for users to download the charts and maps for use in reports and presentations. The site also makes HTML coding available for use in online media.

“AskCHIS NE truly moves forward the center’s mission of democratizing data,” said Bogdan Rau, the project manager for AskCHIS NE. “It’s provided as a public service so that everyone who needs access to quality, authoritative health information can benefit.”

AskCHIS Neighborhood Edition is sponsored by grants from Kaiser Permanente and the California Wellness Foundation.

Heavy website traffic is expected when AskCHIS NE launches. If the site is busy, please try again later.

Visit the UCLA Center for Health Policy Research — and see a demo of AskCHIS NE — at Booth 1043 at the American Public Health Association annual meeting in New Orleans, Nov. 16 – 19. View the schedule for the meeting.

View original article

CATEGORY: NewsComments Off

UC Riverside hosting Inland Empire Black Health Expo


Free event to be held Nov. 22 and is open to the entire community.

Members of region’s African American community are invited to attend the Inland Empire Black Health Expo on the campus of UC Riverside on Saturday, Nov. 22, from 8 a.m. to 4:30 p.m. at the Highlander Union Building.

There is no cost to attend the expo, but those who plan to attend are asked to RSVP online at http://go.ucr.edu/bhe. Free parking is available in Parking Lot 1. The full event flier is available for download.

“The purpose of the expo is to create an environment specifically dedicated to improving health care disparities in the African American community,” said fourth-year neuroscience major Maryam Bello, the president of African Americans United in Science (AAUS) at UCR. “I hope it serves as a catalyst that drives African Americans and health care professionals to become more involved in improving minority health disparities.”

The expo will include workshops and speakers, community resources, information on Ebola, health screenings including blood pressure, health-related vendors, presentations on fitness, heart health, mental health, infectious diseases and more.

“A lot of people don’t realize the simple changes they can make to better their lives,” fourth-year biological sciences in anthropology major and vice president of AAUS Dijon Gatewood said. “I hope that through this expo, we can help the black community become more aware of the importance of health.”

The expo is sponsored by AAUS, in conjunction with Healthy Heritage Movement, UCR African Student Programs, J. W. Vines Medical Foundation, UCR School of Medicine, Riverside Community Health Foundation, the Black Voice News, Western University – College of Allied Health Professionals, PhRMA, PepsiCo, Colgate, Schools First Credit Union, African American Health Initiative, Inland Empire Black Nurses Association, and African-American Family Wellness Advisory Group (AAFWAG).

Organizers said they hope the expo will become an annual event.

View original article

CATEGORY: NewsComments Off

Social status can impact health and happiness


Impacts seen among egalitarian forager-farmers.

A Tsimane leader mediates a dispute between villagers. (Photo by Chris von Reuden, UC Santa Barbara)

In western society, where keeping up with the Joneses — or, better yet, surpassing them — is expected and even encouraged, status matters. So important is it that for many people, physical and emotional wellbeing are directly connected to their place in the social hierarchy.

That’s hardly news to anthropologists at UC Santa Barbara, but they were taken by surprise when research findings indicated that the same relationship exists among the Tsimane, an egalitarian society of forager-farmers in the Bolivian Amazon. Their work, “Political Influence Associates With Cortisol and Health Among Egalitarian Forager-Farmers,” is published online in the journal Evolution, Medicine, and Public Health.

Myriad studies have shown that low social status can have negative effects on health, both in humans and in our non-human primate relatives. This status-health relationship adds moral weight to current debates about the increasing inequality in industrialized societies. What is surprising about the relationship between status and health, the researchers argue, is that the improved access to health care, food, housing and other benefits that money and influence can buy do not fully explain it. Instead, the growing consensus is that the health risks of low status are due in part to the chronic psychosocial stress of the rat race itself, and of perceived social subordination, whether by other individuals or by institutions.

“Status has its obvious rewards in a modern, stratified society — if you were on the sinking Titanic in 1912 and you were high status, then it was more likely there was a place for you on one of the lifeboats,” said Michael Gurven, professor of anthropology at UCSB and senior author of the paper. “Or status is key if it brings you preferential access to arable land and livestock in a land-limited society with rigid rules of inheritance.”

But with the Tsimane, he continued, none of that is relevant. Everyone has access to farmland, and everyone can freely fish, hunt and gather. Villages do have leaders, but no one holds sway over anyone else. If people don’t like the leadership in one village, they simply move to another.

“We’re able to show that there are measurable differences in recognized social status even within the egalitarian context, and that these differences matter,” Gurven continued.

“They’re all equal, and yet social status is important. It impacts their perceptions, their level of stress and their health.”

Read more

For more health news, visit UC Health, subscribe by email or follow us on Flipboard.

CATEGORY: NewsComments Off

Sesame Street helps teach physicians a lesson


Incarceration plays major role in health disparities in U.S., says UC Riverside professor.

UC Riverside’s Scott Allen (left) is seen here with Sesame Street’s Alex, a blue-haired, green-nosed Muppet who has a father in jail, and Brown University’s Josiah Rich (right). (Photo courtesy of Pam Hacker, Sesame Street)

More than two million people are incarcerated in the United States, the highest incarceration rate in the world. So perhaps it comes as no surprise that last year the popular children’s television series Sesame Street introduced a character that has an incarcerated father.

With incarceration having found a home even on Sesame Street, public health practitioners, policymakers and health care providers ought to pay closer attention to incarceration’s impact on health inequality in the country, argue a team of two physicians and a medical researcher in an article published today (Oct. 6) in Annals of Internal Medicine.

Scott A. Allen, M.D., a professor of medicine in the School of Medicine at the University of California, Riverside, and his colleagues report that while many people need to be in prison for the safety of society, a majority are incarcerated due to behaviors linked to treatable diseases such as mental illness and addiction.

“In such cases, incarceration will improve neither the imprisoned person nor the social problem without medical intervention,” Allen writes, along with co-authors Dora M. Dumont, Ph.D., M.P.H., at the Rhode Island Department of Health and Josiah D. Rich, M.D., M.P.H., at Brown University.

Read more

For more health news, visit UC Health, subscribe by email or follow us on Flipboard.

CATEGORY: NewsComments Off