Myths obscure lack of health care for some Asians
Filed under: Health journalism, Hot Health Headline
A focus on “ethnic disparities” can obscure the fact that racial designations are so broad that the disparities within them are just as great as those without.
The latest example? The paper “Barriers to healthcare among Asian Americans,” [press release] by two SUNY Buffalo sociologists. The paper takes on the myth that Asian-Americans are a well-adjusted, monolithic “model minority,” particularly when it comes to access to health care. Instead, language, health literacy, health insurance and immigrant status all conspire to push certain groups of Asian-Americans well below the national average.
Tapped’s Jamelle Bouie discusses the post, then adds a demographic summary to point out how Asian-American economic status can vary based on country of origin.
While Chinese, Japanese, and Korean Americans tend to do well when compared to their white counterparts, the same can’t be said of Vietnamese, Pacific Islanders, and Cambodians, as well as Hmong and Laotians. Among Vietnamese, for example, per capita income is $23,080 – compared with just over $30,000 for whites – with an overall poverty rate of 13.3 percent, compared to 10.5 percent for whites. Likewise, only 13.3 percent of Cambodians and a scant 9.3 percent of Laotians have a bachelor’s degree or higher, compared to nearly 30 percent of whites.
California’s doctors: Aging, white and specialized
Filed under: Health data, Hot Health Headline, Studies
In California Watch’s blog, Joanna Lin breaks down the California HealthCare Foundation’s latest report on the state’s physician supply. Nationwide, a quarter of physicians are over sixty. In California, which leads the nation in doctors nearing retirement, that number is 29 percent. In addition to aging, the state is also faced with particular ethnic disparities among caregivers.
… Latinos represent 37 percent of the state’s population, but 5 percent of its doctors. The disparity is even greater in the Central Coast, Inland Empire and San Joaquin Valley regions, and most severe in Los Angeles County, where 47 percent of the population and only 5 percent of doctors are Latino. Statewide, 18 percent of doctors speak Spanish.
While California led the nation in retention of graduating state medical students, a “substantial proportion” of California doctors come from other states and countries, Lin writes. That number may shrink as the UC system plans to add two more medical schools in the next five years, budget willing. For more specifics, take a look at the report itself. It’s loaded with easy-to-understand summary statistics and beautiful charts and graphs.
State snapshots make it easy to spot disparities in children’s health care
The Data Resource Center for Child and Adolescent Health has broken the 2007 NSCH Child Health and System Performance Profile into what it calls “state snapshots.” These snapshots make it particularly easy to compare all 50 states (and D.C.) across 21 categories, including dental health, access to care, insurance and several chronic conditions. Below, I’ve mapped an indicator of child access to preventative care, one which would appear to correlate strongly with population density.
The Data Resource Center is a project of the Child and Adolescent Health Measurement Initiative (CAHMI), housed at the Oregon Health & Science University.
Update
In the comments, AHCJ board member Felice Freyer noted that it “Would be interesting to compare these numbers with info on percentage of children who have coverage in each state.” So, that’s just what I did. I put together another map, again using 2007 NSCH data and attached it below.
Vaccine waivers contribute to outbreak
Filed under: Health data, Health journalism, Public health
In the wake of California’s public health director’s declaration that whooping cough has reached epidemic status, California Watch’s Christina Jewett looks at public health data and where the number of cases are highest.
She finds the most cases in Marin County, one of the state’s most affluent, and in Fresno County, which has “a vulnerable population gripped with child poverty and other ills.”
One contributing factor, according the Marin’s public health officer, is that more than 7 percent of kindergartners start school without vaccinations. Parents there are signing waivers to opt out of immunizations based on their beliefs that vaccinations are dangerous.
Jewett includes links for more information about such fears and about whooping cough. Her piece also includes the county-by-county data on whooping cough in California.
America suffers from maternal mortality disparities
RaceWire’s Michelle Chen took the time recently to remind readers that, while we are celebrating the decline of infant and childbirth-related mortality worldwide, there are still huge disparities in maternal mortality within the United States. For example, according to 1999-2004 NCHS numbers, top-ranked Maine loses only 1.3 mothers per 100,000 live births; that number is 34.9 in bottom-ranked D.C. and 20.5 in Georgia.
(New York City) Health officials found that of the 161 mothers who died of pregnancy-related causes between 2001 and 2005, Black women were seven times more likely to die than white women. The death rates for Asian and Latina women were twice as high compared to whites. While some affluent neighborhoods like Manhattan’s Chelsea were untouched by maternal mortality, the highest death rates were in enclaves associated with low-income communities of color, like Bed-Stuy, Crown Heights, and Jamaica.
Chen writes that the disparities may be caused by a number of socioeconomic factors, including the lack of health insurance and the impact of health factors like obesity that affect blacks disproportionately.
RaceWire is the blog of ColorLines, which bills itself as “the national magazine on race and politics.”
Health series tries to reach those often left out
Filed under: Health journalism, Hot Health Headline
Kate Dailey of Newsweek has teamed up with Public Radio International for a 10-part series, “DIY Checkup: Taking Control of Our Health.” The project looks at “what people can do to live better, no matter their genetics, history, or economic status.”
Dailey, in a blog post about the series, recognizes that some of the standard pieces of advice, such as going to the gym for exercise or eating fresh fruits and vegetables, are not relevant for significant parts of the population. People who work on their feet all day and people who live in food deserts are not getting the messages in a way that make them relevant to their lives.
As Dailey says, “the language that doctors and journalists often use to talk about personal health often leaves many people out.”
Part one of the series lists things people can do to significantly improve their health. Listen to part one:
Workshop explored health needs of rural residents
Filed under: Health journalism, Health policy, Public health, Studies
Dennis Berens, president of the National Rural Health Association, called media coverage of health reform a failure – but not the only failure in framing the issue for the public.
Kansas psychiatrist Roy Menninger said barriers to mental health services in rural have changed little over the past three decades, with serious consequences.
And while a growing population of seniors are drawing on health resources, soaring childhood obesity rates are another drain in the often impoverished areas, experts on aging and childhood said.
Those were some of the highlights of Rural Health Journalism Workshop 2010 in Kansas City, Mo., on June 4. More than 50 people attended the event, part of the Association of Health Care Journalists’ Midwest Health Journalism Program.
With 15 speakers and other topics including health disparities and oral health, attendees of the free, daylong event left with story ideas and new resources to enhance their reporting.
Read more about the workshop …
Wisconsin’s low Medicaid fees create dental woes
Filed under: Health data, Health journalism, Hot Health Headline
The Wisconsin State Journal’s David Wahlberg reports that access to adequate dental care is a major public health issue throughout the state, especially among Medicaid recipients. Federally funded clinics are starting to fill the gaps, but there is still quite a bit of catching up to do. Waiting lists are long, and it’s the nature of remedial dental care that getting each mouth back on track is a long and involved process.
Photo by dbgg1979 via FlickrDentists told Wahlberg that they are reluctant to serve Medicaid recipients because the state’s reimbursement rates are too low. According to HHS, Wahlberg writes, “Just 23 percent of the state’s enrollees got dental care in 2008. Only Delaware, Florida and Kentucky fared worse.”
Rural areas have only about half as many dentists per person as urban areas do, making the search for dental care even harder in small towns.
That, combined with low fluoride levels in many rural drinking water supplies, means more tooth loss and untreated decay for many rural residents, state health officials say.
“Of all of the holes (in health care), dental care is the biggest and the deepest,” said Greg Nycz, executive director of the Family Health Center of Marshfield, which serves much of rural, northern Wisconsin.
The article is the latest in Wahlberg’s yearlong look at rural health care. Wahlberg will be moderating a panel about oral health for rural residents at next week’s Rural Health Journalism Workshop in Kansas City.
Feds want to fight food deserts
Filed under: Health policy, Hot Health Headline, Public health
The Detroit News‘ Nathan Hurst reports from D.C. on the Healthy Food Financing Initiative, proposed legislation that would commit between $400 million and $1 billion dollars to “building and improving stores where access to fresh food is limited.”
It’s modeled on a Pennsylvania program which provided start-up costs to grocery stores that promised to offer fresh food in low-to-moderate-income areas which didn’t yet have adequate access to such things. Detroit is the sort of city that would benefit most from a boost in urban groceries, Hurst writes.
Photo by paige_eliz via FlickrCarr said the prospect of federal subsidies to increase the number of grocery stores could be a boon to a city where large areas for years have had limited access to fresh produce and meats. In 2003, a University of Michigan study showed Detroit could easily support 41 large supermarkets — which measure more than 40,000 square feet — but at the time had only five with more than 20,000 square feet, and at least two of those have closed since the study was done.
How do these food deserts emerge in the first place? The Cincinnati Enquirer’s Laura Baverman explains by looking into that city’s shrinking grocery selection. Baverman explores several contributing factors, including a lack of the huge lots preferred by big box stores, booming suburbs and struggling independent stores, but in the end she comes back to brutal economic reality:
“You don’t get the sales levels in the inner city that you do out in the suburbs,” said Matt Casey, president of Matthew P. Casey & Associates, a New Jersey-based grocery industry consultant. “You tend to have a lower-income customer base, so they’re not spending as much. They don’t make the impulse buy.”
Related
Report: Health care disparities aren’t getting better
In their coverage of AHRQ’s latest annual quality and disparities reports (Quality PDF | Disparities PDF), most outlets focused on disheartening news on health-care-associated infections, but the disparities report also deserves a second look. It’s 302 pages that can be oversimplified as “disparities still exist, they’re not getting better, and they’re worse in some areas than in others.”
Here are a few of the more interesting bullet points, all pulled from the first 16 pages of summary information.
- For Blacks, Asians, and Hispanics, at least two-thirds of measures of quality of care are not improving (gap either stayed the same or increased).
- For Blacks, only about 20% of measures of disparities in quality of care improved (gap decreased).
- For poor people, disparities are improving for almost half of the quality measures.
- The largest disparities for Blacks, AI/ANs, and Hispanics included the rate of new AIDS cases. The rate for Blacks was almost 10 times as high as the rate for Whites, for Hispanics more than 3 times as high, and for AI/ANs 1.4 times as high.
- Asians were 1.5 times as likely as Whites to report they sometimes or never get care for illness or injury as soon as wanted. Poor people were more than twice as likely as high-income people to report this
problem. - Hispanics were 1.7 times as likely as Whites and poor people were 3 times as likely as high-income people to report poor provider-patient communication.
- Blacks, Asians, AI/ANs, and Hispanics all experienced disparities in the percentage of adults age 50 and
over who received a colonoscopy, sigmoidoscopy, proctoscopy, or fecal occult blood test and in
commended hospital care for pneumonia. - Blacks and Hispanics both had worsening disparities in colorectal cancer mortality from 2000 to 2006.
The report doesn’t stop with bullet points, of course. Anyone who takes a few minutes to page through the other 280-some-odd pages will be rewarded with in-depth information on disparities in a number of specific diseases and issues – including breast cancer, diabetes, HIV, palliative care, mental health and access to health care – all buttressed with charts, graphs, explanations and data.
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Spend a week at the CDC studying public health, meeting sources. Apply for the AHCJ-CDC Health Journalism Fellowships today!
- Reporting on the intersection of health, environment
- Tip sheet: Covering cuts to Medicare reimbursements
- Briefing: Reporting on health reform between now and 2014
- Covering high-risk insurance pools: Tips for reporters
- Health care reform has passed: What's next?
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
