[ Diabetes Solutions ]

Kaiser’s Monthly Update on Health Disparities

This dissertation includes three manuscripts focusing on health disparities between whites and Japanese with regard to measures of diabetes and subclinical atherosclerosis in the EBCT and Risk Factor Assessment among Japanese and U.S. A community-based participatory action research model guided coalition activities from conceptualization through implementation. Most participants perceive that the HDCs are successful and worth the effort. The impacts of racial and economic health disparities on medical care costs for diabetes were determined by first calculating the proportionate differences between the diabetes prevalence for whites, African Americans, and American Indians enrolled in Medicaid and the diabetes prevalence among all whites in North Carolina. Publications Billimek J, August KJ. The Secretary shall ensure that any such oversampling does not reduce the oversampling of other minority populations including African-American and Latino populations. It provides an overview of the latest in health disparities research.

The Diabetes Initiative demonstrated the feasibility, effectiveness, and cost effectiveness of diabetes self management programs in real world settings such as Federally Qualified Health Centers and community based programs. However, there is limited information on how to address the specific needs of high-risk populations such as new immigrants, low-income earners, seniors and those working shifts. All three providers serve high numbers of low-income and uninsured or underinsured patients. The CVP also works with local, regional, and national policy makers to provide input on policy solutions to improving health, and in particular for vulnerable and minority populations. Using data from the national HIV surveillance records, this study, analyzed trends in racial/ethnic disparities in rates of AIDS diagnoses in all 50 states and the District of Columbia. Mice lacking GRB14 are lean, and more sensitive to insulin than normal mice. Recent CAHDR advances have explained the role of cholesterol in HIV entry and replication within a cell.

For example, reducing disparities in effective asthma treatment by 10% for African American workers could save more than $1,600 per person annually in medical expenses and costs of missed work. Racial disparity in U.S. diagnoses of acquired immune deficiency syndrome, 2000-2009. American Journal of Preventive Medicine. 2012 Oct; 43(5): 461-466). This study analyzed the impact of patient-centered medical homes on reducing disparities in the quality of pediatric primary care, using data from the National Survey for Children’s Health. The study found that having a patient-centered medical home (PCMH) was associated with a significant reduction in unmet health needs across racial and ethnic groups.

Only with a greater understanding of the determinants of these inequities can health disparities be fully addressed. The authors suggest that PCMHs should prioritize obtaining racial and ethnic data on patients and incorporating patient experience data into program evaluations. (Aysola J, Bitton A, Zaslavsky A, et al. All-cause and CVD mortality in Native Hawaiians. Medical Care. Source: National Institute of Diabetes and Digestive and Kidney Diseases, U.S. For blacks in the United States, health disparities can mean earlier deaths, decreased quality of life, loss of economic opportunities, and perceptions of injustice.

The analysis found that, among Hispanics wi th diabetes, undocumented immigrants were less likely to have seen a health care provider in the previous six months, report having a usual source of care, and have health insurance compared to documented immigrants. These findings build on existing research by detailing new differences by documentation status. The authors suggest additional research using primary data collection and quantitative analyses be conducted to further understand the causal factors that influence Hispanic immigrants’ decisions to seek medical care. (Do E, Matsuyama RK. Healthcare utilization among Hispanic immigrants with diabetes: investigating the effect of U.S. documentation status. Journal of Immigrant Minority Health.

2012 Oct; DOI: 10.1007/s10903-012-9729-9). This study examined racial and ethnic disparities in health status, access to care, and use of services among U.S. adolescents using data from the 2003 National Survey of Children’s Health. The analysis found lower rates of coverage and care and poorer health status among racial and ethnic minority groups compared to whites and particularly significant disparities for specific groups. For example, American Indians/Alaska Natives had the largest number of disparities at age 18, Latinos had the highest uninsured rate, and African Americans had the largest number of health status disparities. Increases among older women were generally more attenuated. (Lau M, Lin H, Flores G.

Racial/ethnic disparities in health and health care among U.S. adolescents. Health Services Research. Whitman S, Silva A, Shah A, Ansell D. This study examined the impact of socioeconomic status, maternal health, complications during pregnancy, and fetal health status on racial disparities in fetal death. Using hospital delivery data from three states between 1993 and 2005, the researchers found that these factors influenced fetal death disparities, but the role of the factors varied across groups. The authors conclude that additional research is needed to understand the role of mediating factors and suggest that those amenable to intervention should be the focus of immediate efforts to reduce fetal death disparities.

Map out the structure for a 60-second video segment about the study. Factors that mediate racial/ethnic disparities in U.S. fetal death rates. American Journal of Public Health. 2012 Oct; 102(10): 1902—1910). This study quantified and sought to understand disparities in patient satisfaction between English- and Spanish- speaking Hispanic patients using data from the Medical Expenditure Panel Survey. The analysis found that, relative to Spanish-speakers, English-speaking Hispanics were more likely to be satisfied with provider communication and that acculturation, health insurance, and education all contributed to this difference.

2011. (Villani J, Mortensen K. Decomposing the gap in satisfaction with provider communication between English- and Spanish-speaking Hispanic patients. Journal of Immigrant Minority Health. 2012 Oct; DOI: 10.1007/s10903-012-9733-0). This study examined disparities in health care access and utilization between U.S.-born and foreign-born Asian Americans using data from the National Health Interview Survey. The study found that, overall, foreign-born Asians had less access to care and lower utilization compared to their U.S.-born peers, with some variation by country of birth.

These findings highlight key barriers to care for Asian immigrants, including socioeconomic status, language, and culture. (Ye J, Mack D, Fry-Johnson Y, et al. Health care access and utilization among U.S.-born and foreign-born Asian Americans. Journal of Immigrant Minority Health. 2012 Oct; DOI: 10.1007/s10903-011-9543-9). To explore racial and ethnic disparities in pregnancy outcomes among Medicaid enrollees, this study analyzed Medicaid Analytic eXtract data from 2005 to 2007 in 14 southern states. The study found that, among Medicaid enrollees, African-American women were more likely than non-Hispanic white and Hispanic women to have longer hospital stays and pregnancy complications.

Hispanic women had the lowest rate of adverse pregnancy outcomes. The study estimated that eliminating disparities in adverse pregnancy events could save between $114 and $214 million annually in Medicaid costs in the 14 states studied. (Zhang S, Cardarelli K, Shim R, et al. Racial disparities in economic and clinical outcomes of pregnancy among Medicaid recipients. Maternal and Child Health Journal. 2012 Oct; DOI: 10.1007/s10995-012-1162-0).

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