Monday, December 01, 2008 thru Friday, December 05, 2008

• American Indian Health Care Advocates, Lawmakers Look to Next Administration for Passing of Reauthorization Bill
  [Dec 01, 2008]

American Indian Health Care Advocates, Lawmakers Look to Next Administration for Passing of Reauthorization Bill
[Dec 01, 2008]

      With Congress expected to adjourn for the year without passing the Health Care Improvement Act reauthorization bill (S 1200), Senate Indian Affairs Committee Chair Byron Dorgan (D-N.D.) and American Indian leaders are looking to the incoming Obama administration for support, the Fargo Forum reports. The bill, approved by the Senate, would allocate $35 billion over the next 10 years for American Indian health care programs, including screening services and mental health programs, and would improve access to health care. The bill also would increase tribal access to Medicare and Medicaid, prompt new construction and modernization of reservation health clinics, and seek to recruit more American Indians into the health care professions.

Jacqueline Johnson, director of the National Congress of American Indians, said her group plans to push for passage of the bill during the next Congress. Dorgan said he believes that President-elect Barack Obama will be a "much more aggressive advocate" for American Indian communities. Obama campaigned heavily in Indian Country -- "more than any presidential candidate before him" -- and said he supports more funding for Indian Health Service and better services at IHS clinics, the Forum reports. He also has promised to create the first White House position to oversee American Indian affairs.

Johnson said, "Having a president start (paying attention to Indian issues) earlier in his term gives him an opportunity to accomplish so much," adding, "The president sets the tone" (Jalonick, Fargo Forum, 12/1).

Budget Request
In related news, a group of U.S. senators has sent President Bush a letter requesting that federal agencies include in their 2010 budgets funding approved for American Indians in the President's Emergency Plan for AIDS Relief, Indian Country Today reports (Capriccioso, Indian Country Today, 11/28). Legislation (S 2731) approved by the Senate in July reauthorized PEPFAR at $50 billion over five years. The legislation calls for $2 billion of that total to be directed toward American Indian health care and other programs.

Over the next five years, the funds would go to health services, building and rehabilitating health clinics, improving community sewer and water systems, tribal police departments and courts, constructing tribal detention centers, and investigating and prosecuting crimes on reservations (Kaiser Health Disparities Report, 7/17).

The letter -- signed by Dorgan and Sens. John Thune (R-S.D.), Jon Kyl (R-Ariz.), John Tester (D-Mont.), Lisa Murkowski (R-Alaska), Pete Domenici (R-N.M.) and Tim Johnson (D-S.D.) -- said the funds are needed to strengthen access to health care and to improve public safety resources in Indian Country.

Jon Lauck, a senior adviser to Thune, said the funding is a "brand new authorization created in July 2008 and thus was not included in the FY 2009 budget that passed Congress in early 2008." He added that the letter was directed to Bush because "he is the individual that puts out the original budget in February. It is usually easier once things get to Congress if the money is already in the president's budget."

Congressional leaders likely will send a similar letter to Obama, according to Indian Country Today. Lauck added that if neither Bush nor Obama includes the funds in their proposed budgets, Thune "will be pursuing options within Congress" (Indian Country Today, 11/28).

The letter is available online.

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Blacks, Men Who Have Sex With Men Remain Most Affected by HIV/AIDS
[Dec 01, 2008]

      Monday marks the 20th year for World AIDS Day, and the virus is continuing to affect the black community and men who have sex with men at disproportionate rates, the McClatchy/Detroit Free Press reports (Satyanarayana [1], McClatchy/Detroit Free Press, 11/29). An estimated 56,300 people in the U.S. contract HIV annually, and the black community accounts for almost half of new HIV/AIDS cases nationwide, the Northwest Indiana Post-Tribune reports.

HIV infections are growing fastest among black women, who are 15 times more likely to contract the virus than white women, according to CDC. AIDS-related causes are the leading cause of death among black women ages 25 to 34, and the third leading cause of death among black women ages 35 to 44. Andrea Perez, communities of color program manager for the Indiana Department of Health, said the No. 1 method of HIV transmission among black women is heterosexual sex. She added that it is unclear why the rate for black women is so high (Snelling, Northwest Indiana Post-Tribune, 12/1).

In Detroit, between 2002 and 2006, half of all new infections each year were among black men, according to the McClatchy/Free Press. In addition 84% of people ages 13 to 24 in the city diagnosed with HIV are black. Michigan next year plans to launch a new awareness effort targeting the group. Over the next year, the Detroit Department of Health and Wellness Promotion is hoping to partner with 50 churches to help administer 15,000 HIV tests and educate church members on prevention measures.

Renee McCoy, the city's HIV/AIDS director, said, "Our goal is to figure out what our culture needs" (Satyanarayana [1], McClatchy/Detroit Free Press, 11/29).

Related articles
The Free Press published several articles about HIV/AIDS and the black community. Headlines appear below.

• "The Doctors: New Approaches Give Patients Hope" (Satyanarayana [2], Detroit Free Press, 11/29).
  
  
• "An Advocate: He Aims To Stop Stigma, Fight HIV" (Satyanarayana [3], Detroit Free Press, 11/29).
  
  
• "An Activist: She Works To Educate High-Risk Women on HIV Prevention" (Satyanarayana [4], Detroit Free Press, 11/29).
  
  
• "A Supporter: He Uses His Story To Spread Word on Getting Tested" (Satyanarayana [5], Detroit Free Press, 11/29).
  

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U.S.-Born Blacks More Susceptible to Developing Asthma Than Those Born in Other Nations, Study of Dorchester, Mass., Finds
[Dec 02, 2008]

      Blacks born in the U.S. are nearly three times more likely than blacks born outside of the U.S. to have asthma, according to a study published in the November issue of the Journal of Asthma, Boston Globe reports. The study, led by Tufts University researcher Doug Brugge, was conducted in response to a request from parents in Dorchester, Mass., who were concerned about a high number of asthma cases in their community, according to the Globe.

For the study, in 2005 and 2006, the research group -- including 20 parents of children with asthma and Harvard medical students -- surveyed Dorchester community residents. The analysis included information on 290 adults and 157 children. Researchers found that 30% of U.S.-born blacks had been diagnosed with asthma, compared with 11% of blacks who were born in another country. A previous study by Brugge found similar findings among foreign-born Asians and Hispanics.

According to the Globe, foreign-born blacks could have fewer asthma cases because of more sunlight exposure during childhood and less time spent inside, "where mold, cockroach droppings and other [asthma] triggers dwell." In addition, the disparity could be because "natives of other nations, especially those in the developing world, may encounter more infections growing up [and thus] their immune systems often ignore threats such as dust mites and mold." The same exposure among those with less immunity can cause allergic reactions that lead to asthma, the Globe reports.

George O'Connor, director of the Adult Asthma Program at Boston Medical Center, said, "There may be a price to be paid for growing up in a more sterile, hygienic environment with fewer infections as a child," such as the U.S., and "the price to be paid is that your immune system may develop more along the lines of promoting allergic responses."

Researchers noted that the findings represent a snapshot of a single neighborhood but reflect "an emerging recognition that scientists should stop regarding racial and ethnic groups as monoliths," according to the Globe (Smith, Boston Globe, 12/1).

The study is available online.

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Arkansas HIV/AIDS Task Force Final Report Requests $3M for Awareness Efforts, Testing Sites
[Dec 03, 2008]

      The Arkansas HIV/AIDS Minority Task Force on Monday released its final report and said it will request $3 million in state funding over the next two years to fight the spread of HIV/AIDS in minority communities and establish testing sites, the Arkansas Democrat-Gazette reports (Frago, Arkansas Democrat-Gazette, 12/2).

The 19-member task force was formed in January by Gov. Mike Beebe (R) to examine HIV/AIDS among the state's minority populations and ways to strengthen HIV/AIDS prevention and treatment among blacks, Hispanics and other minorities in the state. The task force held a series of meetings in the state's four congressional districts to hear public comment on the issue, as well as to discuss HIV/AIDS incidence among minorities and the efficacy of current programs. The committee submitted a report of its findings and recommendations to Beebe, leadership in the state House and Senate, and Arkansas' Department of Health (Kaiser Health Disparities Report, 7/17).

In the report, task force members said the money is needed to create counseling services and 15 HIV testing sites in black, Hispanic and other high-risk communities around the state. The report proposed an annual budget of $150,000 to hire two staff members to manage the services and to pay for overhead costs, such as office space, supplies and travel reimbursement. The task force said the testing and counseling sites would cost $975,000 annually. They also budgeted $225,000 annually for an HIV/AIDS awareness campaign.

In the past seven years, HIV/AIDS prevention efforts in the state have received $5,938 annually, according to Tere Roderick, head of HIV prevention for the state Health Department. "Our state has not addressed this issue," she said. Task force Co-Chair Rick Collins said that the state's tight budget might make it difficult for the state to allocate the requested money. But he added, "We're keeping our fingers crossed. We hope our state will step up to the plate" (Arkansas Democrat-Gazette, 12/2).

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Race, Ethnicity Likely Affects Emotional Well-Being of Cancer Patients, Study Finds
[Dec 03, 2008]

      Black cancer patients report having poorer physical and social well-being than their white counterparts but better emotional well-being, according to a study published in the November issue of the Journal of Pain and Symptom Management, Reuters Health reports. Previous studies have indicated that blacks have poorer physical health than whites.

For the study, lead researcher Deepa Rao of Northwestern University's Feinberg School of Medicine and colleagues examined how race or ethnicity might affect the social and emotional well-being of cancer patients. The Functional Assessment of Cancer Therapy-General survey included responses from 502 black patients and 396 white patients in their mid-50s who had breast, colon, head/neck, lung cancer or AIDS-related malignancies. About 66% of the participants were women.

Black participants had worse responses to the statement, "I feel ill," but not as strong responses to the statements, "I worry that my condition will get worse" and "I am content with the quality of my life right now."

After taking into account possible contributing factors -- such as diagnosis, marital or insurance status, education and the patients' own reports on their performance status -- the researchers found that race is a significant predictor of physical, social, emotional and functional well-being.

The researchers suggested that further studies be conducted to examine the socioeconomic factors associated with findings and whether they are more common among vulnerable populations, such as people with low health literacy skills or language barriers (Hendry, Reuters Health, 12/2).

An abstract of the study is available online.

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Study Finds Fibroid Growth Differences Between Black, White Women
[Dec 02, 2008]

      Fibroid growth in women over age 35 declines with age for white women, but not for black women, which might explain why black women typically have more symptoms than white women, according to a study published in the December issue of Proceedings of the National Academy of Sciences, Reuters Health reports.

Fibroids -- usually benign growths in the walls of the uterus that can grow to be quite large and cause heavy menstrual periods, pelvic pain and other symptoms -- occur in about 25% of all women and are the leading cause of hysterectomy in the U.S., according to Reuters Health. Researcher Donna Baird of the National Institute of Environmental Health Sciences and colleagues conducted the Fibroid Growth Study, in which they examined fibroid growth in 38 black and 34 white women ages 24 to 54. The researchers measured the fibroids using an MRI four times over a 12-month period.

According to the study findings, age and race both influenced the growth rate of the fibroids. The number of fibroids also affected the growth rate. Researchers suggested that "it may be possible to extend the follow-up time for assessment of fibroid growth" beyond the current practice of evaluation at six-month intervals. They added that if "further research supports our findings that tumor growth rates decline in white women as they age, those approaching perimenopause might choose to delay treatment and wait for menopause when tumors are likely to shrink" (Reuters Health, 12/1).

An abstract of the study is available online.

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Black Women With Cervical Cancer Appear To Have Fewer Chemotherapy-Related Side Effects Than White Women, Study Finds
[Dec 04, 2008]

      Black women who have advanced and recurrent cervical cancer seem to have fewer side effects from a commonly used form of chemotherapy than white women, according to a study published in the November issue of the American Journal of Obstetrics and Gynecology, Reuters Health reports. Cisplatin, a platinum-based version of chemotherapy, is a common treatment for various types of cancer.

For the study, lead researcher Steven Plaxe of the University of California-San Diego examined data pooled from three studies that included information on 374 white and 125 black women who were treated with a variety of chemotherapy drug combinations for cervical cancer, including cisplatin.

Researchers found that 63% of black women, compared with 82% of white women, had severe neutropenia, a side effect related to frequent chemotherapy that is characterized by a drop in a white blood cell called the neutrophil. Black women also were less likely to have two other chemotherapy-related side effects -- leukopenia, an abnormally low white blood cell count, and thrombocytopenia, a reduction in platelet cells.

In addition, when compared with white women, black women did not have an increased risk of the cancer worsening or of dying from their disease, according to the study. Plaxe said that the findings "support efforts directed at encouraging enrollment of all eligible women, particularly minorities, into clinical research studies" (Reuters Health, 12/3).

An abstract of the study is available online.

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Report Released by Group Alleges Discriminatory Practices at CVS Pharmacies Across U.S.
[Dec 04, 2008]

      A coalition of public interest groups on Thursday are expected to gather outside of several CVS pharmacies in New York City and four other cities to protest what they say are unequal services provided to minority communities across the country, the New York Daily News reports. CVS has more than 6,000 pharmacies nationwide. The coalition is expected to release a report that alleges "questionable product quality, overcharging and consumer safety issues" by the pharmacy chain in minority neighborhoods (Moritz, New York Daily News, 12/4).

The report, signed by a number of labor and immigrant advocacy groups, alleges that CVS has fewer stores in minority communities than in white neighborhoods across the country, Eva Millona, executive director of the Massachusetts Immigrant and Refugee Advocacy Coalition, said. The coalition also claims that the pharmacy chain keeps certain products -- such as condoms, infant formula and baby food -- in locked cabinets in stores in communities with larger minority populations, while such items are not locked up at stores in white neighborhoods. "The report highlights the inequity with which CVS serves some of its customers," Millona, said, adding, "We urge CVS to address that."

CVS spokesperson Michael DeAngelis said in a statement that "ethnicity plays no role in loss-prevention procedures" and that the report is "based on inaccurate and outdated information." He added, "CVS Caremark does not discriminate in our policies or store operations, or tolerate discrimination of any kind in our organization" (Wong, Boston Globe, 12/4).

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HIV/AIDS Prevention Efforts Failing To Reach Hispanic Community in the South, Report States
[Dec 04, 2008]

      HIV/AIDS prevention efforts in Alabama and other Southern states fail to reach the Hispanic population, despite a rise in cases among Hispanics, according to a report released on Monday by the Latino Commission on AIDS, the Birmingham News reports. The two-year investigative report -- "Shaping the New Response: HIV/AIDS & Latinos in the Deep South" -- looked at HIV rates and programs in Alabama, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee.

For Alabama, the report found that while there are clinical services available for people living with HIV/AIDS, few services employed bilingual health care professionals. The number of Hispanics diagnosed with HIV in the state increased from 22 in 2005 to 31 in 2007, according to the report. One HIV clinical care facility based in Birmingham reports a doubling of cases among Hispanics within the last year. Montgomery AIDS Outreach reports that about 3% of its clients are Hispanic.

Tykeysha Boone, director of education for AIDS Alabama, said a lack of funding has prevented the organization from hiring bilingual staff, even though language barriers represent a large challenge for the agency. She added, "Every culture has different barriers and different things that appeal to them and different things they find innovative. That's probably what the issue is right now -- trying to figure out what is the most innovative approach" (Stock, Birmingham News, 12/3).

The report is available online.

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'Taboo' About HIV/AIDS in Hispanic Community Affects Group's Testing Rate, Opinion Piece Says
[Dec 02, 2008]

      "With the threat of so many deadly diseases out there, AIDS awareness seems to have taken a backseat," Maria Salinas, a television anchor at Noticiero Univision, writes in a Fresno Bee opinion piece, adding, "We have seen an increase in campaigns to educate people on the threat of heart disease, cancer and diabetes, among others, but AIDS continues to be the unmentionable disease."

HIV/AIDS is a particularly taboo topic among Hispanics, who according to CDC "are disproportionately affected by the HIV virus," Salinas writes. Hispanics are the second most at risk ethnic group, and although they account for 15% of the population, Hispanics represented 19% of AIDS diagnoses in 2006, according to Salinas.

"There certainly is a cultural component to this," Salinas writes, adding, "Because it is a disease that is linked to drug use, sex and homosexuality, it is just not talked about in socially conservative [Hispanic] families" and as a result, Hispanics do not get tested as often as other groups.

She continues, "Yet so many lives could be saved if people realized that taking a test to determine possible exposure to [HIV] is nothing to be ashamed of. It is, in fact, an act of courage," concluding, "But risking your life and that of others is not" (Salinas, Fresno Bee, 12/1).

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Absence of 'Frank Talk' About HIV/AIDS Hurts Black Women in Washington, D.C., Opinion Piece Says
[Dec 03, 2008]

      "If ever there was a case for unvarnished sex education in public schools, the ongoing AIDS epidemic in black America ought to be it," columnist Courtland Milloy writes in a Washington Post opinion piece, adding, "[H]ow can we teach [HIV prevention] if we can't talk frankly?" Milloy writes that he is "focusing on women and AIDS ... because it's up to women to save their own lives" and that "too many men are not trying to protect" women from sexually transmitted infections. "Most of the time, they are just trying to have sex," he writes, adding, "Quite frankly, you would have thought more women would have caught on by now."

According to Milloy, "In the district, the number of women living with AIDS increased by more than 76 percent in six years -- nine out of 10 of them black women." He adds that AIDS-related illnesses are the fourth leading cause of death among black women ages 45 to 54, and 9% of all pediatric HIV/AIDS cases in the U.S. occur in the district. "Blame the man all you want, but it's the mother and child who suffer most," he writes. "There's certainly no shortage of public service announcements aimed at reducing infection rates among African-Americans," Milloy writes, adding, "But most consist of preachy platitude, politically correct and 'culturally sensitive' pablum ... The results should not be surprising." He concludes that "in the absence of frank talk, we could at least help young girls ... by getting them to serve a few weeks at an AIDS hospice. Careless sex would likely lose its sheen once they realize that their lovers could be the Grim Reaper in disguise" (Milloy, Washington Post, 12/3).

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Event Date: 12/11/2008
Host: Northwest Portland Area Indian Health Board and National Rural Health Association
Event: Minority and Multicultural Health Conference, December 11-12
Location: Albuquerque, N.M.
Event Contact: E-mail, marsh@NRHArural.org; or visit Web site.