As health professionals, nurses are well aware of health disparities in communities of color. Some patients will live shorter life spans simply because of their race, ethnicity, education or income.
Raising awareness about health inequities is a constant effort, but this critical issue is highlighted in April, which is National Minority Health Month. This year’s theme: “Prevention is Power: Taking Action for Health Equity” emphasizes the critical role of prevention in reducing health disparities.
The combined cost of health inequities and premature deaths were estimated to be $1.24 trillion between 2003 and 2006, according to the Joint Center for Political and Economic Studies.
From AIDS/HIV to cancer to obesity to tuberculosis, racial and ethnic minorities are more likely to be affected in disproportionate numbers. Health disparities among African Americans and Latinos in 2009 cost private insurers an additional $5.1 billion.
Consider these statistics:
▪Of 197,090 diagnoses of HIV-infection from 2008-2011, Blacks were 47% of the total.
▪African Americans, American Indians and Alaska Natives are twice as likely to be diagnosed with diabetes and Native Hawaiians and Pacific Islanders are more than three times as likely to receive the same diagnosis.
▪Latinos are twice as likely to die from liver cancer.
▪African American women are 40% more likely to die of breast cancer than white women.
▪About five out of 10 Latinos and four out of 10 blacks aged 50 or older never had a colonoscopy or sigmoidoscopy compared to three out of 10 older whites.
▪Black women have more than double the rate of extreme obesity [16.4%] as white and Latino women [7.4% and 7.6%].
Preventive services, such as diabetes screening and pap smears, are game-changing. So is a honest discussion about healthy eating, fresh-food deserts and lack of exercise. People can do better when they know better.
Nurses are the most trusted professionals. Educate patients as well as loved ones to help reduce preventable disease, disability and death.
Robin Farmer is a freelance journalist with a focus on health, education and business. Visit her at www.RobinFarmerWrites.com
As you know, April is National Minority Health Month, our opportunity to increase public awareness of the health disparities that unfortunately still impact ethnic and minority groups in the American population.
Because the theme this year is “Prevention is Power: Taking Action for Health Equity,” nurses are perfectly poised to take up the banner for highlighting the role of prevention in closing the health disparities gap.
After all, nurses naturally take on the responsibility for patient education. Sometimes, though, they’re hesitant to take that health message beyond patient rooms and expand its reach to the wider community. But it’s easy to do that and a wonderful way to increase the visibility of nurses as a critical part of the nation’s healthcare team. Here’s how.
Send in a letter to the editor of your state, city, or community newspaper, with a call to action for improving the health of our minority populations. You can do it under your own signature or that of a group of nurses if you belong to an association, for instance. Does that sound like a daunting task? It doesn’t have to be — if you keep these tips in mind.
*List a few talking points that you want to emphasize, with statistics that back up your points, perhaps centered on disparities that affect your racial or ethnic minority or that of your patients or co-workers. For instance:
“African American women are 34 percent more likely to die of breast cancer than White women.” (Source: Centers for Disease Control and Prevention, “REACH U.S. Finding Solutions to Health Disparities: At A Glance 2010,” National Center for Chronic Disease Prevention and Health.)
*Stick to just a few talking points so that you can keep the letter short – about 150-300 words – making it more easier for a publisher to slot in the paper.
*Or, respond to something covered in that newspaper about minority health disparities or prevention within the past 72 hours. Present a perspective that’s a bit different based on your own unique experience as a nurse.
*Be sure to end with your contact information, including your name, title, organization, address, and the phone number or email address where you can be most easily reached. (Editors with usually contact you to confirm this information before printing your letter.)
*In case your letter isn’t published, don’t give up — the paper may have been overwhelmed by reader letters on that topic or others. Try another angle — there are many ideas for you to consider at http://minorityhealth.hhs.gov.
Not feeling too creative? Take the sample letter below and customize it to represent your own views.
Dear Editor,
The health disparities you highlight in [cite article and date of article you are responding to], carry a steep cost for this nation and dampen our productivity and the well-being of our friends and neighbors. Here in [insert city, state etc.] we contribute to that burden by having [add key reference data for your community e.g. some of highest rates of childhood obesity among Hispanic children; the lowest percentage of mothers seeking prenatal care across all racial and ethnic groups; and the highest rates of death from diabetes among African Americans].
We must confront this persistent problem and achieve better health for everyone in the United States. The federal government has made a commitment to end health disparities and its National Stakeholder Strategy for Achieving Health Equity provides us with a blueprint to help reduce health inequalities and build healthier communities across the nation. Elected officials, health providers, and community leaders and residents here in [name location] must take that blueprint and work together to set goals and identify solutions that will help racial and ethnic minorities and other underserved people in our [insert locality – state/city/county etc.] live longer and healthier lives.
[Signed]
Jebra Turner is a freelance health writer in Portland, Oregon, but you can visit her online at www.jebra.com.
Women vaccinated with one dose of a human papillomavirus (HPV) vaccine had antibodies against the viruses that remained stable in their blood for four years, suggesting that a single dose of vaccine may be sufficient to generate long-term immune responses and protection against new HPV infections, and ultimately cervical cancer, according to a study published in Cancer Prevention Research.
“The latest Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention on vaccination coverage indicates that in 2012, only 53.8% of girls between 13 and 17 years old initiated HPV vaccination, and only 33.4% of them received all three doses,” said Mahboobeh Safaeian, PhD, an investigator in the Division of Cancer Epidemiology and Genetics at the National Cancer Institute (NCI) in Bethesda, Maryland.
“We wanted to evaluate whether two doses, or even one dose, of the HPV 16/18 L1 VLP vaccine [Cervarix] could induce a robust and sustainable response by the immune system,” she added. “We found that both HPV 16 and HPV 18 antibody levels in women who received one dose remained stable four years after vaccination. Our findings challenge previous dogma that protein subunit vaccines require multiple doses to generate long-lived responses.”
Data for this study are from the NCI-funded phase III clinical trial to test the efficacy of Cervarix in women from Costa Rica. About 20% of the women in the study received fewer than three doses of the vaccine, not by design.
The researchers looked for the presence of an immune response to the vaccine (measured by antibody levels) in blood samples drawn from 78, 192, and 120 women who received one, two, and three doses of the vaccine, respectively, and compared the results with data from 113 women who did not receive vaccination but had antibodies against the viruses in their blood because they were infected with HPV in the past.
They found that 100% of the women in all three groups had antibodies against HPV 16 and 18 in their blood for up to four years. Antibody levels were comparable for women receiving two doses six months apart and those receiving the full three doses.
The researchers also found that while antibody levels among women who received one dose were lower than among those who received the full three doses, the levels appeared stable, suggesting that these are lasting responses. In addition, the levels of antibodies in women from the one- and two-dose groups were five to 24 times higher than the levels of antibodies in women who did not receive vaccination, but had prior HPV infection.
“Our findings suggest promise for simplified vaccine administration schedules that might be cheaper, simpler, and more likely to be implemented around the world,” said Safaeian. “Vaccination with two doses, or even one dose, could simplify the logistics and reduce the cost of vaccination, which could be especially important in the developing world, where more than 85% of cervical cancers occur, and where cervical cancer is one of the most common causes of cancer-related deaths.”
In some parts of the world, including Chile and British Columbia, two doses of HPV vaccine is now the recommended vaccination program, according to Safaeian. But for a single HPV dose, “while our findings are quite intriguing and show promise, additional data are needed before policy guidelines can be changed,” she clarified. “For instance, it is important to note that persistence of antibody responses after a single dose has not been evaluated for Gardasil, the quadrivalent HPV vaccine that is more widely used in the United States and many other countries.”
The constant stress of dealing with physical and emotional demands as a nurse may leave you feeling exhausted, irritable and disconnected. Some days, it may be a struggle to head into work. You may find yourself increasingly needing a “mental health day” and calling in sick.
Draining emotions on the job come and go. Or they can be signs of burnout, a psychological condition that affects professional performance and one’s mental well-being. Long hours, limited staff and feeling undervalued can create burnout, which impacts not only nurses, but patients and healthcare systems as well.
Taking extra care of yourself is just one way to guard against this debilitating condition. Consider these other measures to protect yourself:
Eat healthy, exercise regularly and sleep well. It’s difficult to take care of others when you neglect your own health. Practicing good self-care is one of the best preventive steps against nurse burnout.
Be honest with your feelings. As a caregiver, you ride a roller coaster of emotions on any given day. It’s important to express feelings of sadness, grief, anger and remorse. Avoid suffering in silence. Sometimes a good cry can work wonders.
Communicate with your co-workers. Your colleagues can better understand what you are experiencing than someone who is not a nurse. They can provide invaluable support. Speak up when you need help and return the favor.
Become an advocate for a healthy work environment. Start a planning recognition event, morale committee or reward activities.
Schedule “me” time. Replenish your soul by engaging in activities that feed it, from hanging out with family and friends to making time for hobbies or a new book. It’s easier to deal with stress when you have opportunities to relax and enjoy yourself on a regular basis.
Leave your job-related stress at work. Create boundaries between the workplace and home with specific activities that you do consistently to mark the end of the work day. For example, once at home, soak in the tub, call a loved one or play your favorite music.
See Our Champions of Nursing Diversity
Sign up now to get your free digital subscription to Minority Nurse
