A foundation for future growth

In an effort to combat the major health issues plaguing American Indians, the University of Kansas Medical Center and the American Indian Health Research and Education Alliance announced plans to create a Center for American Indian Community Health, with help from a $7.5 million grant from the National Center for Minority Health and Health Disparities and the National Institutes of Health. This new Center is sure to bring some much-needed care to the American Indian community, through improving education, outreach, research, and community resources.

Compared to the U.S. population as a whole, American Indians are astronomically disproportionately affected by a number of diseases: they are 420% more likely to die from diabetes, they are 100% more likely to die from tobacco-related illnesses, they have the lowest screening rates for breast and colorectal cancer, and they have the lowest five-year cancer survival rate.

Researchers plan to use the grant money in their efforts to recruit American Indian high school and college students into the health sciences programs at University of Kansas. No American Indians had been enrolled in the programs until recently. Now, three students have graduated, five are enrolled, and several more should be matriculating. Outreach has also been performed at the Haskell Indian Nations University to find students who might be interested in the public health program. 

Historically, American Indians have been very distrustful of outsiders, including medical care providers, after a tumultuous and tragedy-filled history since explorers first came to America. The hope is that these graduates will return to their communities to improve the quality of care and work toward eliminating health disparities.

New federal grants help minority infants in Utah

Every newborn enters the world with the unlimited promise and potential of a life yet to be lived. However, alarming research conducted in Utah has revealed that all babies may not have the same chances, particularly those born to African Americans and Pacific Islanders. According to the Utah Department of Health’s Center for Multicultural Health, Pacific Islander infants (those under 12 months) experience about 8.8 deaths out of every 1,000 births, compared to about 4.5 deaths out of every 1,000 births statewide. Utah’s infant mortality rate hasn’t exceeded eight deaths per 1,000 births in over 20 years. In light of these facts, the U.S. Department of Health and Human Services recently decided to provide over $130,000 over a three-year period to help specialists study mortality rates within various populations in Utah.

Center specialist April Bennett says the information gathered from this process will be used to implement many interventions and outreach programs for minority women. Surveys will be conducted to help expecting mothers identify obstacles that they may experience during pregnancy, such as maternal obesity, smoking, poverty, etc. The ultimate goal is to help them lead better lifestyles.

The number of uninsured in the state has risen in the past 10 years, with Hispanics holding the highest number at 35.7%, compared with only 11.1% of all Utahans. In 2001, 25.8% of Hispanics were uninsured. For uninsured mothers, this means inadequate prenatal care, which can lead to premature labor and put the lives of their infants at risk. Various health department surveys have shown that African Americans have the highest rates of pre-term births of all infants in Utah, one of the underlying issues contributing to a higher infant mortality rate in the state. But, the U.S. Department of Health and Human Services is determined to make an impact on this issue immediately, starting with studying the contributing factors, such as insufficient insurance and a lack of access to care.

Saving nursing homes

As aging is inevitable, the need for specialized care also becomes inevitable. But what can you do if your access to quality elderly care is severely limited? Unfortunately, this is the case for many urban communities.

According to a study conducted at Brown University, the United States has lost 5% of its nursing homes (over a nine-year period), with closures being twice as likely to occur in minority neighborhoods. Not only does this leave families with fewer options, but it’s causing some moral dilemmas as well. Families are now finding themselves obliged to put their loved ones into low quality health care facilities. Also, the nursing homes may be farther away from their home communities, and if those elderly are from low income areas, their family and friends may not be able to afford the frequent trips to visit them.

What can be done to make sure additional nursing homes are not affected by the closures? Because polls have shown that people only go to nursing homes as a last resort, Dr. Mitchell H. Katz of the San Francisco Department of Health suggests that Medicare should help pay for assisted living and contribute other alternatives to nursing home care. If putting more money into new nursing homes is not an option, then the focus should be shifted towards other options like assisted living, home-based care, or community-based care. Katz says doctors should demand “high-quality nursing homes in the communities where people have lived and doctors should be more present” in order to raise the quality of care for the elderly.

Kidney transplants: does ethnicity affect patients’ chances?

According to a recent study in the Journal of the American Society of Nephrology (JASN), some ethnic groups can be found at the bottom, or missing, from waitlists for kidney transplants. Though the exact causes are not known, experts have a variety of theories and are working hard to address this issue.

At the University of Washington in Seattle, Yoshio Hall, M.D., and his colleagues were determined to fi nd some answers. In their study, they surveyed 503,090 non-elderly adults from different ethnic backgrounds who had started dialysis between the years of 1995 and 2006. In 2008, the researchers had some answers. Of all waitlisted patients, white non-Hispanics were 40% more likely to receive a transplant than African Americans, Hispanics, Asian Americans/Pacific Islanders, and others minorities. Also of note, the rates of deceased-donor transplantations after dialysis were lowest in American Indians/Alaska Natives (2.4%) and highest in non-Hispanic whites (5.9%) and Asians (6.4%).

Today, the reasons behind these discrepancies are still not completely clear, which highlights the need for further investigation. Some theories point to socioeconomic factors, while others suggest a lack of organ availability, or even cultural isolation.

Dr. Hall believes that more research and understanding could result in the reduction of racial, ethnic, and socioeconomic disparities for kidney transplants in the future.

Ethnicity and health outcomes

In one of the first studies of its kind, researchers at the University of Michigan’s School of Public Health have illustrated how physical health outcomes within the black population vary based on environment.

The research compared two populations, African Americans and Caribbean blacks, and the varied relationships between ethnicity, nativity, depressive symptoms, and physical health in these two populations. According to the research, a Caribbean-born black person living in the United States has a higher chance of being physically healthy than an African American or a U.S.-born black person of Caribbean descent, which was the least healthy group.

The survey relied on participants’ self-ratings of their physical health, so depressive symptoms were also noted. The study also demonstrated how important linking the physical and mental areas of wellness were. In all three groups, increased depressive symptoms lead directly to predictable health outcomes.

The research also discovered the least healthy age for all groups ranged 45–59, a time when doctors expect people to be improving their health. Middle age is also when family, career, and social life typically converge, so health might be a last priority when these other obligations are more demanding.

This study gives researchers a better understanding of the health patterns within different racial groups, and how environment can have a major effect on a person’s health.