Monday, January 12, 2009 thru Friday, January 16, 2009

• SCHIP Bill Passes Senate Finance Committee
  [Jan 16, 2009]

 

SCHIP Bill Passes Senate Finance Committee
[Jan 16, 2009]

      By a 12-7 vote, the Senate Finance Committee on Thursday approved SCHIP reauthorization and expansion legislation that could add four million children to the program, the AP/Boston Globe reports (AP/Boston Globe, 1/16). The bill, introduced by committee Chair Max Baucus (D-Mont.), would expand the program by $31.5 billion over four-and-one-half years. The House passed a similar bill (HR 2) on Wednesday. The bill now goes to the floor, where Senate leaders are expected to amend Baucus' language into the House-passed bill and send it to conference to resolve any differences.

The Finance Committee adopted an amendment by Sen. John Rockefeller (D-W.Va.) that would allow states to waive the federally mandated five-year waiting period for documented immigrants seeking public health benefits in the case of pregnant women and children. The provision, included in the House bill, could add "several billion dollars" to the cost of the measure, CQ Today reports. According to CQ Today, the provision "was the only major point of disagreement" between the House and Senate versions of the bill.

Republican members of the committee were "upset" over several facets of the bill, CQ Today reports. They expressed concern regarding provisions that would eliminate the waiting period for documented immigrants, loosen citizen and residency documentation requirements, change policies on how to deal with people who transfer from private insurance to SCHIP and lessen income limits.

Republicans proposed several motions to increase restrictions for immigrants seeking SCHIP coverage; however, just one was adopted. The provision, submitted by Finance Committee ranking member Chuck Grassley (R-Iowa), would require states to review citizenship or legal residency status of SCHIP beneficiaries during the process of verifying beneficiaries' income levels. Under the provision, SCHIP enrollees who lose their documented status while enrolled in the program would be disenrolled. The committee also adopted an amendment from Sen. Olympia Snowe (R-Maine) that would allow states to offer dental insurance to children who have private health coverage but do not have dental coverage.

Grassley said that passing SCHIP reauthorization would complicate efforts to pass health care overhaul legislation later in the year. "In a lot of ways it makes more sense to do a simple extension of SCHIP for two years so we can work through how to fold SCHIP into a program that covers everyone," he said (Armstrong, CQ Today, 1/15).

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House Passes SCHIP Reauthorization, Expansion Bill; Senate To Act Soon
[Jan 15, 2009]

      The House on Wednesday voted 289-139 to approve a bill (HR 2) renewing and expanding SCHIP to about four million additional children, the New York Times reports (Pear, New York Times, 1/15). Under the expansion, similar to one that was vetoed by President Bush in 2007, children in families with incomes of up to three times the federal poverty level would qualify for the program. Supporters of the bill say it will raise the number of children covered by SCHIP from around seven million to around 11 million (Armstrong [1], CQ Today, 1/14). The measure extends the program by four-and-one-half years at a cost of $32.3 billion, on top of the current $25 billion cost of the program (New York Times, 1/15). SCHIP's current authorization expires March 31 (Kaiser Daily Health Policy Report, 1/14). The bill would almost be completely funded by a 61-cent-per-pack increase in the federal cigarette tax (New York Times, 1/15).

The bill also includes a provision that would allow states to waive the federally mandated five-year waiting period for documented immigrants seeking to receive public benefits in the case of children and pregnant women (Levey, Los Angeles Times, 1/15). Supporters of the provision say about 400,000 to 600,000 children would be added to SCHIP if all states choose to cover children of documented immigrants and pregnant documented immigrants (Kaiser Daily Health Policy Report, 1/14).

GOP Objections
Republicans raised several objections to the bill, including that tobacco revenues were not increasing quickly enough to offset the cost of the bill, that some children who were already privately covered would be included and that the bill does not require states to ensure that the poorest children are covered first, according to the New York Times (New York Times, 1/15). House Republicans issued a policy statement Wednesday detailing their objections to the expansion bill. The statement said, "Increasing the amount of federal tax dollars flowing to states that consciously choose to provide benefits to children of these higher-income families before enrolling already eligible poor and low income children is the wrong policy and sends the wrong signal" (Murray/Connolly, Washington Post, 1/15).

House Ways and Means Committee ranking member Dave Camp (R-Mich.) said, "I think the real concern is eligibility is being increased without making sure those children who really qualify for SCHIP are covered, and, secondly, really the oversight of the program is lacking because they're really not requiring the kind of verification that needs to be done" (Edney, CongressDaily, 1/14).

Democrats' Comments
House Speaker Nancy Pelosi (D-Calif.) said the passage is a "monumental achievement for our country and certainly for this Congress" (Lengell, Washington Times, 1/15). Democrats also dismissed Republicans' complaints over the bill's funding source. Pelosi said, "Forty days in Iraq equals over 10 million children in America insured for one year. We certainly can afford to do that" (Freking, AP/Philadelphia Inquirer, 1/15). House Energy and Commerce Health Subcommittee Chair Frank Pallone (D-N.J.) said, "Soon we will have a new president who has committed himself to reforming our nation's health care system so every American can access affordable and quality health care," adding, "The bill ... makes a down payment on that promise" (Los Angeles Times, 1/15). President-elect Barack Obama said that the bill is "good economic policy," and asked the Senate to act quickly to pass the bill "so that it can be one of the first measures I sign into law when I am president" (Bendery, Roll Call, 1/14).

Senate Bill
The Senate Finance Committee on Thursday will begin mark up on a similar bill (AP/Philadelphia Inquirer, 1/15). The Senate bill does not include the waiver for immigrant pregnant women and children. Finance Committee Chair Max Baucus (D-Mont.) said he did not include the provision in the bill because it was not part of the bipartisan legislation negotiated in 2007, but said he supports the waiver. Committee member John Rockefeller (D-W.Va.) on Thursday is expected to propose an amendment that would add the waiver to the bill. The amendment likely will be approved, according to CQ Today (Armstrong [2], CQ Today, 1/14). The Senate measure is expected to pass "soon after" Obama's inauguration, the Washington Times reports (Washington Times, 1/15).

Broadcast Coverage
NPR's "All Things Considered" on Wednesday reported on the passage of the bill. The segment includes comments from several House members (Rovner, "All Things Considered," NPR, 1/15).

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Politico Examines Debate Over SCHIP Bill That Would Lift Eligibility Restrictions for Documented Immigrants
[Jan 14, 2009]

     
Politico on Tuesday examined the debate over SCHIP renewal and expansion legislation that also would lift eligibility restrictions for documented immigrants. The House is expected to vote on the legislation Wednesday. According to the Politico, the House vote "could set the tone for future debates" on immigrant issues (O'Connor, Politico, 1/13).

The bill would expand SCHIP to cover four million additional children. It also would repeal a rule barring documented immigrants from receiving federal health benefits during their first five years in the U.S. The rule originally was written into a 1996 law overhauling the nation's welfare programs and Medicaid and was expanded to include SCHIP when the program was created in 1997 (Kaiser Health Disparities Report, 1/13). A similar Senate bill would not lift the waiting period.

Jennifer Ngandu -- spokesperson for the National Council of La Raza, which has lobbied for a repeal of the five-year waiting period for SCHIP -- said, "We really believe that this is the first opportunity for the president-elect and the Congress to demonstrate their commitment to the Latino community."

According to Politico, "many GOP lawmakers still view the proposed repeal as a 'wink-wink, nod-nod' for immigrants in the country illegally to receive federally funded health coverage through state-run Medicaid programs." Other Republicans argue that the budget shortfalls mean that many states cannot afford to expand their Medicaid or SCHIP programs, and the federal government would have to increase its contributions for the expansions to happen, Politico reports. According to Politico, Republican opposition is not expected to prevent the legislation from "easily passing."

Rep. Xavier Becerra (D-Calif.) said, "It's not just about Hispanic families; it's an issue of providing some sense of health care security for all families" (Politico, 1/13).

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SCHIP Bill Expected To Lift Eligibility Restrictions in Federal Health Care Programs for Documented Immigrant Children, Pregnant Women
[Jan 13, 2009]

      Congress this week is preparing to vote on SCHIP renewal and expansion legislation that would allow about four million additional children to be eligible for the program, the New York Times reports. The bill, scheduled for vote this week in the House, is "very much like" the legislation vetoed by President Bush in 2007, House Majority Leader Steny Hoyer (D-Md.) said. Under the bill, SCHIP would provide health benefits for about 10 million children, compared with the more than six million under the current charter. While the exact cost of the expansion is not clear, it is expected to "more than double" the over $5 billion annual cost of the program for the federal government, the Times reports. The bill would be funded by a 61-cent per pack increase in the federal cigarette tax. The current SCHIP charter is set to expire March 31 (Pear, New York Times, 1/13).

According to the Times' "The Caucus," "Given its strong support in both parties, approval of the measure is a lock." Hoyer said the legislation is even more important than in 2007, given the ongoing economic recession. He said, "Obviously we all know that one of the aspects of losing a job is, in many instances, losing your health insurance as well. We are very concerned that we will have a lot of children vulnerable in America" (Hulse, "The Caucus," New York Times, 1/12).

The measure would repeal a rule barring documented immigrants from receiving federal health benefits during their first five years in the U.S. The rule originally was written into a 1996 law overhauling the nation's welfare programs and Medicaid and was expanded to include SCHIP when the program was created in 1997 (Meckler, Wall Street Journal, 1/13). The provision would give states the option of covering documented immigrant pregnant women and children under Medicaid and SCHIP (New York Times, 1/13). President-elect Barack Obama, who is expected to sign the bill, has expressed his support for repealing the provision. According to the Times, experts say between 400,000 and 600,000 documented immigrant children could gain access to coverage under the bill (New York Times, 1/13).

Two House legislative aides said the House version of the bill will give states the choice of whether to include these immigrants in their SCHIP program. However, it is not clear whether a repeal of the ban will be included in a Senate version being prepared by Senate Finance Committee Chair Max Baucus (D-Mont.). According to the Wall Street Journal, Baucus has said he wants to repeal the ban but it is unclear whether he will include a repeal in the bill he presents to the Finance Committee (Wall Street Journal, 1/13). As of Monday, Baucus had not included the provision (New York Times, 1/13). The Baucus version is expected to be introduced to the Finance Committee this week, with a vote "soon after," according to the Journal. Some Republican senators at a meeting last week expressed concerns about repealing the ban but did not say that it would cause them to vote against the bill, according to people familiar with the issue. However, Finance Committee ranking member Chuck Grassley (R-Iowa), who supports upholding the ban, said that adding the provision to the final bill would make it "difficult for many Republicans to support final passage." According to the Journal, some Republican lawmakers already oppose the SCHIP bill regardless of the ban (Wall Street Journal, 1/13).

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New Jersey Lawmakers Expected To Meet To Discuss Ways To Reduce Racial Disparities in Prenatal Care
[Jan 12, 2009]

      New Jersey lawmakers will hold a legislative meeting on Thursday to discuss ways to address racial inequalities in access to prenatal health care, the AP/Philadelphia Inquirer reports. Assembly member Sheila Oliver (D), chair of the Assembly Human Services Committee, planned the hearing (Delli Santi, AP/Philadelphia Inquirer, 1/12).

A 2008 state Department of Health and Senior Services found that teenagers, minorities and single women in New Jersey all have a higher risk of poor birth outcomes and also are less likely than others to receive early prenatal care (Kaiser Health Disparities Report, 9/4/08). Oliver said, "Worries such as lack of transportation and reduction of services at our clinics shouldn't be preventing women, most notably teenagers and African-American women, from getting the care that they need to ensure their babies have the best chance at being born healthy and strong."

State Health and Senior Services Commissioner Heather Howard is scheduled to discuss a statewide campaign that seeks to raise awareness of prenatal care at the hearing. In addition, Oliver is sponsoring legislation that calls for obstetric services to be continued in the event that a clinic closes or reduces its hours. The bill also would authorize the commissioner to allocate money from the Health Care Stabilization Fund to support obstetrics at a financially distressed health care center.

Oliver said, "New Jersey is too good to rank near the bottom when it comes to the state of health care for expectant mothers and their children" (AP/Philadelphia Inquirer, 1/12).

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CDC Reports Rise in STIs, Chlamydia Rates; Blacks Disproportionately Affected
[Jan 14, 2009]

      Blacks were disproportionately affected by sexually transmitted infection rates in 2007, including chlamydia rates that reached a record high and syphilis rates that increased for the seventh consecutive year, according to a CDC report released on Tuesday, Reuters Health reports (Dunham, Reuters Health, 1/13).

The report found 1.1 million chlamydia diagnoses were reported in 2007. The chlamydia rate was 370 reported cases per 100,000 people in 2007 -- a 7.5% increase since 2006.

Reported gonorrhea diagnoses -- which peaked in the 1970s at one million and then declined until a few years ago -- totaled 355,991, or 119 reported cases per 100,000 people in 2007. The rate was similar to that reported in 2006.

The syphilis rate continued to rise in 2007, as it has since 2000, with 11,466 diagnoses reported, or 3.8 cases per 100,000 people. This marks a 15% increase from 2006 (Engel, Los Angeles Times, 1/14).

Black women ages 15 to 19 have the highest rates of chlamydia and gonorrhea. Gonorrhea rates for blacks overall were 19 times higher than for whites, according to the report. Blacks make up 12% of the U.S. population, but account for about 70% of gonorrhea cases and nearly 50% of chlamydia and syphilis cases, the report said (Reuters Health, 1/13). Minorities have been disproportionately affected by STIs in previous year reports, with American Indians Alaska Natives and Hispanics at a lesser extent, according to the Times.

Public health officials said the disparities can be attributed to several factors, including socioeconomic and cultural issues, lack of access to health care and distrust of the health care system.

John Douglas, director of CDC's Division of STI Prevention, said that the increase in reported chlamydia cases could be attributed to better detection and an increase in testing, especially among women. In addition, providers are now using a more sensitive test to screen for the infection. However, health officials believe that the reported number of chlamydia diagnoses might not be the true number of infections -- which they predict could be closer to three million -- because so many infections go unidentified (Los Angeles Times, 1/14).

The report is available online.

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Some Sexually Transmitted Infections Increasing in South Dakota; Lack of Education, Health Services on American Indian Reservations Partly To Blame, Officials Say
[Jan 12, 2009]

      The number of gonorrhea and chlamydia cases in South Dakota peaked at record levels last year, and HIV/AIDS cases also are on the rise, according to the state Department of Health's 2008 infectious disease report, the Sioux Falls Argus Leader reports. The number of chlamydia infections reached an all-time high of 2,948 in 2008, up by 328 since 2007, according to provisional data in the report. Gonorrhea infections increased by 29.4% to 370. There were 34 HIV/AIDS infections reported in 2008, compared with 25 in 2007.

State epidemiologist Lon Kightlinger said higher numbers of chlamydia cases in western counties were related to higher rates among American Indians, likely because of lack of adequate screening programs in Indian Health Services clinics on the reservations.

Charon Asetoyer, executive director of the Native American Women's Health Education Resource Center, said a lack of sexual education in schools is partly to blame for the increases. She also suggested that a reduction to health care resources at state and federal levels for American Indian health care is contributing to the spread of infectious diseases among the group.

"You cannot take health care away from communities and expect a community to maintain their health without information and resources," Asetoyer said, adding, "The statistics are proof that young people need sex education to be able to protect themselves. If you do not have the tools to protect yourself -- the information -- you are going to see an increase in the number of sexually transmitted diseases" (Brandert, Sioux Falls Argus Leader, 1/12).

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Young People Might Overestimate Condom Use, Study Finds
[Jan 15, 2009]

      Some teenagers and young adults might overestimate how often they use condoms during sex, according to a study published recently in the Archives of Pediatrics and Adolescent Medicine, Reuters Health reports. Eve Rose of Emory University and colleagues conducted the study among 715 black women and girls ages 15 to 21 who were enrolled in an HIV prevention program. Researchers asked the participants how many times in the past two weeks they had sex and how many times they used a condom. The participants also provided vaginal fluid samples to be screened for Y chromosome DNA, or evidence of sperm.

The researchers found that among the women who had sex during the past two weeks, 186 reported condom use every time. However, of the women who reported consistent condom use, 34% had Y chromosome DNA in their fluid samples. According to the researchers, the reasons for the discrepancy -- including that the participants were mistaken, had misused the condoms or had provided the "socially desirable" response -- are not known. They add that "regardless of whether the problem is condom user error or misreporting, the unfortunate result, in terms of risk for [sexually transmitted infections] and HIV, is the same." The study's findings also have implications for young people's sexual health and studies on the issue, the researchers said. They added that studies using both self reports and objective measures of condom use might provide a more accurate understanding of young people's sexual behavior and their STI risk (Reuters Health, 1/14).

An abstract of the study is available online.

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Common Hepatitis C Treatment Less Effective in Hispanics Than Whites, Study Finds
[Jan 15, 2009]

      The standard hepatitis C treatment appears to be less effective in Hispanics than in whites, likely because of unknown biological differences, according to a study published on Thursday in the New England Journal of Medicine, the Miami Herald reports. For the study, lead researcher Lennox Jeffers, a professor of medicine at the University of Miami Miller School of Medicine, and Paul Martin, chief of hepatology at the UM medical school, studied 269 Hispanics and 300 non-Hispanic whites with hepatitis C. Participants were given the standard combination treatment of pegylated interferon -- sold under the name Pegasus -- and ribavirin during a period of 48 weeks (Tasker, Miami Herald, 1/14).

The treatment was considered effective if participants became virus-free for six months after receiving the drug combination. The treatment was effective for 49% of white participants, compared with 34% of Hispanics. Among Hispanics, the virus was either never cleared from the patient's bloodstream or it returned again later, according to the South Florida Sun-Sentinel. The findings were similar to previous studies that found Pegasus was ineffective in nearly 75% of black patients

Martin said, "There may be factors in individuals, in their immune response that may be related to their ethnicity" (LaMendola, South Florida Sun-Sentinel, 1/14).
Jeffers added, "We don't know the exact mechanism" causing the different response. Jeffers noted that because blacks and Hispanics traditionally are underrepresented in clinical trials, it is difficult to determine which drug combinations are effective for them. He added that more recent clinical trials have been more diverse.

Martin said new drugs might prove more effective for blacks and Hispanics (Miami Herald, 1/14). Jeffers noted that combinations of new and old drugs were effective in two-thirds of white patients and about half of minorities. "They may not reverse the disparities, but they will work better for everyone," he said (South Florida Sun-Sentinel, 1/14).

An abstract of the study is available online.

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Report Alleges Inadequate Medical Treatment of Female Immigrant Detainees in Arizona
[Jan 14, 2009]

      Women held in three of Arizona's five immigrant detention facilities receive inadequate medical care, according to a report released on Tuesday by University of Arizona's Southwest Institute for Research on Women, the AP/Tucson Citizen reports. Arizona is the nation's biggest crossing point for undocumented immigrants, according to the AP/Citizen. Immigration and Customs Enforcement officials use five detention centers in the state to house 3,000 of 28,750 immigration detainees held daily nationwide.

For the report, third-year law students interviewed 42 people, including 21 women who were or had once been a detainee in the state. Two of the detainees were family members of the researchers and 19 were lawyers or social workers. The report focused on issues such as failing to recognize the mental health needs of the detainee, family separation, inadequate access to telephones and legal materials, and the penal conditions, such as shackling of women who are not being held for criminal offenses, according to the AP/Citizen.

The researchers cited specific cases, including a woman who was six-months pregnant and went without prenatal care for more than one month and another woman with cervical cancer who waited several months to see a nurse and was seen by an oncologist only after an emergency. Alessandra Soler Meetze, executive director of the Arizona Civil Liberties Union, said, "The sad thing is that these horror stories continue."

Katrina Kane, Arizona ICE detention and removal field director, said that those interviewed represent less than 0.0003% of the more than 72,000 immigrant detainee population in Arizona before being deported in fiscal year 2008. She added that all the medical facilities ICE uses are required to comply with the agency's national detention medical standards, and detainees are allowed to make no-cost phone calls to designated officials and legal organizations and counsel (Rotstein, AP/Tucson Citizen, 1/14).

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Utah Blacks Face Significant Health Disparities, Report Finds
[Jan 16, 2009]

      Utah's black residents have higher rates of smoking, uninsurance and infant mortality than other residents, according to a report by the state Department of Health's Center for Multicultural Health released on Thursday, the Salt Lake Tribune reports. Blacks represent 1.5% of Utah's population, which is about 400,000 people. According to the report, blacks smoke and lack health insurance at twice the rate of the entire state population. In addition, nearly 50% of black women do not receive adequate medical care, and black infants have about twice the risk of death as infants of other races.

Laurie Baksh, a state reproductive health epidemiologist, said much of the high rate of infant death is related to a similarly high rate of premature births among blacks. In general, half of premature births are because of maternal or fetal illnesses while the other half is unexplained, according to the Tribune. Steve Alder, chief of the University of Utah's division of public health and director of its Office of Global Health, said the disparities in part can be attributed poverty. He said, the report "highlights the need to think about how we can tailor our efforts to try and bring up different populations to have the standard of health we've come to expect in our society." Betty Sawyer, director of the faith-based health group Harambee African-American Tobacco and Health Network, said racism also is a factor.

State officials plan to target low-income and minority women with a program that promotes wellness before pregnancy. The health department received a $1 million federal grant to fund the program (May, Salt Lake Tribune, 1/16).

The report is available online (.pdf).

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Health Care Coverage Should Be Extended to Undocumented Immigrant Children in Iowa, Opinion Piece Says
[Jan 12, 2009]

      The Iowa Legislature this year needs to include the "uninsured, undocumented immigrant child" in legislation "guaranteeing all eligible children health insurance by 2011," Sen. Jack Hatch (D-Iowa), chair of the Senate Health & Human Services Budget committee, and Sen. Joe Bolkcom (D-Iowa), chair of the Senate Ways & Means Committee, write in a Des Moines Register opinion piece. The state Legislature last year approved legislation that guarantees eligible children health insurance by 2011. According to Hatch and Bolkcom, undocumented immigrant children were "left out" of the plan. They ask, "What does the state hope to achieve by promoting the perpetuation of a subclass of sick kids within our state, increasing the costs that are associated with disease and illness, all while putting our own kids at risk?"

They continue, "Studies have shown that allowing [undocumented immigrants] access to primary care health services is the best and cheapest way to keep them healthy." Hatch and Bolkcom write, "We are already providing health services to undocumented children in the emergency rooms of our community hospitals," which "is the single most expensive venue to provide health care services. It is far more cost-effective to provide care in an organized fashion."

"Through the proposal that will be presented this legislative session, we hope to join the ranks of other states that have decided to provide access to health care programs to undocumented immigrant children," Hatch and Bolkcom write. "There is no justifiable purpose in denying health care coverage for these kids" (Hatch/Bolkcom, Des Moines Register, 1/12).

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Columnist Examines Weight Loss Study Comparing Black Women From U.S., Nigeria
[Jan 16, 2009]

      Washington Examiner nutrition columnist Mark Sisson on Wednesday examined a recent study looking at the effect of diet and exercise on weight among black women. For the study, which was published in the journal Obesity, researchers led by the Loyola University Health System compared the weight, activity levels and diets of a group of black women living in Chicago with a group of women living in rural Nigeria. The average weight of women in the Chicago group was 184 pounds and women in the Nigeria group weighed 124 pounds on average.

According to Sisson, the "researchers found no discernable difference in calories burned due to physical activity between the two groups of women," but an analysis of their diets concluded that "diet is a more likely explanation for why women in the Chicago cohort weigh more than their Nigerian counterparts." The Nigerian women typically followed a diet rich in fiber and carbohydrates; the Chicago women, however, had diets that were high in fat and processed foods, according to Sisson. Researchers suggested that diet might be more important than exercise when it comes to weight loss, according to Sisson. Researchers also said that weight loss might not be as easy without dietary changes.

He writes, "While these findings are certainly interesting," it is "important to remember that exercise has more benefits than a smaller number on the scale," such as lower blood pressure and cholesterol levels, improved mental health and mood, and a reduced risk of several chronic conditions. He concludes that the "key to good health is to follow a nutritious diet and hit the gym on a regular basis" (Sisson, Washington Examiner, 1/14).

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Arkansas Group Launches $150,000 Grant Program for Community HIV/AIDS Advocacy Groups
[Jan 16, 2009]

      The Arkansas Minority Health Commission has designed a new grant program aimed at fighting HIV/AIDS among minority populations at a local level, the group announced Wednesday, the Arkansas Democrat-Gazette reports. The commission will begin offering up to $150,000 in grants this year for community-based groups that work to educate people about HIV/AIDS, offer testing and services, or develop policies, Wynona Bryant-Williams, the commission's executive director, said. She added that commission officials "really want to be more proactive" in the fight against HIV/AIDS. Applications for individual grants -- which range from $15,000 to $50,000 -- are due by Feb. 6, and the awards will be announced in March. Creshelle Nash -- the commission's medical director who also is a professor with University of Arkansas for Medical Sciences' College of Public Health and a physician at the UAMS Medical Center -- said the commission is "looking for partners, we are looking for collaborators because minority health is everyone's health."

The Democrat-Gazette reports that about 7,375 HIV/AIDS cases have been reported in Arkansas in the past 25 years, with 44% of them occurring among black and Hispanic populations. About 15.6% of the state's population is black and 5% is Hispanic. Nash said that the social disparities of minority groups in health care are "the most shocking and the most inhumane."

Bryant-Williams said the obstacles to preventing the spread of HIV among minority populations are "multilayered" and include issues like poverty, lack of health care access, social misconceptions and poor education. She added that people "have this facade that they're indestructible" and that many believe HIV/AIDS will not affect them because it was seen as only a "gay man's disease" when it was first discovered. Nash said conversations about prevention and the risks of HIV/AIDS need to occur within families, churches and schools. Rick Collins -- chair of the Arkansas HIV/AIDS Minority Task Force and co-executive director of Future Builders Inc., a not-for-profit HIV/AIDS awareness, counseling and testing group for local Arkansas communities -- said the group consistently finds people who do not understand the virus or how to prevent transmission. He added that many black men are hesitant to take precautions or be tested. "A lot of people still don't realize where the disease comes from," he said, adding, "People are engaging in sexual activity, and they're really not protecting themselves" (Park, Arkansas Democrat-Gazette, 1/15).

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New York Initiative Uses Mobile HIV Testing To Raise Awareness
[Jan 13, 2009]

      The New York Times recently examined the use of mobile health vans in New York's Westchester County to administer HIV tests to members of the community. According to the Times, Westchester County has the highest HIV prevalence in the state, outside of New York City. Joshua Lipsman, the county health commissioner, estimates that about 3,000 to 5,000 people in Westchester County are HIV-positive, 20% of whom are unaware of their status.

The program is part of a larger initiative between the county's Department of Health and local social service organizations to address the health disparity between blacks and whites. A study commissioned by the county in 2005 found that blacks in Westchester have higher rates of illness than whites and often delay seeking care. The Times reports that the disparity is "particularly acute" with HIV and that 50% of all cases in the county are among blacks, who account for 14% of the population. According to the health department, Hispanics comprise about 18% of the county's population but represent almost one-third of the HIV-positive residents.

According to the Times, one obstacle for public health officials in fighting HIV is reaching people who do not receive regular health care. The mobile health vans have added beauty parlors and barber shops to their list of stops in an effort to reach more people and address fear and stigma associated with the virus, according to Carol Morris, executive director of the Mount Vernon Neighborhood Health Center. Morris, whose clinic administered 10,000 HIV tests in 2008, said people "worry someone might think they are involved in risky behavior" if they take an HIV test, and the program is "trying to have people understand that getting the AIDS test is like getting an immunization."

Za'id Ali -- HIV project coordinator for Open Door Family Medical Centers, which is one of the agencies sponsoring a mobile unit -- said they have had six positive tests so far this year and that young people have begun to seek out the unit for HIV testing, counseling and condoms (Gruen, New York Times, 1/8).

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Dental Clinic Expansion, Grant, Mobile Health Clinic, Other Efforts Seek To Reduce Racial, Ethnic Health Disparities
[Jan 16, 2009]

      The following highlights efforts and grants that seek to reduce racial and ethnic health disparities.

• Framingham, Mass.: The Framingham Mental Health & Substance Abuse Health Disparities Project, which seeks to identify and address barriers to mental health care and substance abuse treatment services for local Hispanics, will launch on Friday, the MetroWest Daily News reports. The Blue Cross Blue Shield Foundation of Massachusetts and the MetroWest Community Health Care Foundation are funding the project. Its launch will include a public meeting to discuss the access issues and several mental health services providers will be available on site (Mineo, MetroWest Daily News, 1/14).
  
  
• Grand Ronde, S.D.: The Housing and Urban Development Indian Community Block Grant Program has awarded more than $3.2 million in grants to the Confederate Tribes of Grand Ronde and seven other tribes in the Pacific Northwest to fund infrastructure projects, the Salem Statesman Journal reports. The Grand Ronde tribe received $500,000 to expand its dental clinic (Much, Salem Statesman Journal, 1/14).
  
  
• Kannapolis, S.C.: The Salisbury Post on Thursday profiled health disparity nutrition expert Sangita Sharma who has joined the University of North Carolina Nutrition Research Institute. According to the Post, Sharma "pioneered ways to measure the nutritional intake of previously unstudied populations in some of the most remote regions on earth." Her studies focus on the causes of cancer, heart disease and diabetes in different ethnic groups and developing community programs to reduce their risks. Sharma said she hopes to establish similar research projects in Kannapolis and work with different ethnic groups to improve nutrition and lower risk factors for disease (Ford, Salisbury Post, 1/15).
  
  
• National Diabetes Education Program: NDEP on Monday launched a bilingual awareness campaign targeting Hispanics with diabetes, their families and health care workers to promote healthy eating. As part of the program -- "It's more than food, it's life" -- resources such as recipe books, posters, and additional tools for Hispanic diabetics and community health care workers will be available online. NDEP officials partnered with several national Hispanic organizations to develop the program and also consulted with nutritionists to create healthy Hispanic recipes (Maul, PRWeek, 1/13).
  
  
• New Orleans, La.: The March of Dimes and Daughters of Charity Services of New Orleans offer no-cost prenatal care to local Hispanic women through two mobile units called "Mom & Baby Mobile Health Centers," the New Orleans Times-Picayune reports. Using 2006 funds from the Qatar Katrina Fund and the people of Qatar, since 2007 one of the mobile health centers has partnered with local churches to offer culture and language-appropriate prenatal care to underserved Hispanic women. Between three and 15 women in their 20s and 30s who often speak little English and have transportation problems use the services daily, according to the Times-Picayune (Gershanik, New Orleans Times-Picayune, 1/15).
  

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Study Looks at Relationship Between Alcohol Advertisements and Alcohol Use in New York City Black Neighborhoods
[Jan 13, 2009]

      "Association Between Residential Exposure to Outdoor Alcohol Advertising and Problem Drinking Among African-American Women in New York City," American Journal of Public Health: Researchers Naa Oyo Kwate and Ilan Meyer -- both professors of sociomedical sciences at the Columbia University Mailman School of Public Health -- studied 139 black women between ages 21 and 49 who lived in Central Harlem, New York City. Participants reported having at least one alcoholic beverage per month in the past six months and had no formal history of alcohol or substance abuse. Thirty-one percent of the participants were found to be "problem drinkers" -- engaging in certain behaviors such as feeling the need to drink first thing in the morning or feeling guilty about drinking. "We found that, on average, exposure to each alcohol ad in a woman's residential block was associated with a 13% increase in the odds of being a problem drinker," Kwate said. "This finding is significant for public health because residents in the study area were highly exposed to alcohol advertisements, and the associations between exposure and outcome persisted after we controlled for other potential causes of problem drinking," Kwate added. Researchers recommend further investigation to determine other possible causes of problem drinking and the role exposure to alcohol advertisements might play in causing the drinking problems (Kwate/Meyer, Mailman School of Public Health release, 1/12).

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