Monday, August 25, 2008 thru Friday, August 29, 2008

• Number, Percentage of Uninsured U.S. Residents Decreased in 2007, Including Among Some Minority Groups, According to U.S. Census Bureau
  [Aug 28, 2008]

Number, Percentage of Uninsured U.S. Residents Decreased in 2007, Including Among Some Minority Groups, According to U.S. Census Bureau
[Aug 28, 2008]

      The number and percentage of uninsured U.S. residents declined in 2007 to 45.7 million people, or 15.3% of the population, according to an annual U.S. Census Bureau report released Tuesday, USA Today reports (Cauchon/Appleby, USA Today, 8/27). In 2006, 47 million people, or 15.8% of the population, were uninsured (Alonso-Zaldivar, AP/Kansas City Star, 8/26). For the report, researchers analyzed data from the Current Population Survey of the 50 states and Washington, D.C. (U.S. Census Bureau release, 8/26).

The survey also found that uninsurance rates differed by race:

• 32.1% of Hispanics were uninsured in 2007, down from 34.1% in 2006, remaining the group with the highest percentage of uninsured;
  
• Blacks' rate decreased from 20.5% to 19.5% during the period;
  
• Asian-Americans' rate increased from 15.5% in 2006 to 16.8% in 2007; and
  
• Whites' rate declined from 10.8% to 10.4%, and the (New York Times graphic, 8/27).
  

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HIV Spreading in New York City at About Three Times the National Rate, Study Finds
[Aug 28, 2008]

      HIV is spreading in New York City at about three times the national rate, with an incidence of 72 new HIV infections per 100,000 people, compared with 23 new infections per 100,000 people nationwide, according to a study released Wednesday by the New York City Department of Health and Mental Hygiene, the New York Times reports (Chan, New York Times, 8/28).

The study's findings are based on a new HIV testing method developed by CDC that can determine when an HIV infection occurred. Previous data did not distinguish recent infections from those that occurred years earlier, according to the health department. About 100,000 New York residents are living with HIV, health officials said (Honan, Reuters, 8/27). According to the study, 4,762 New York residents contracted HIV in 2006 (New York Times, 8/28). Health officials attributed the higher rate of new HIV infections in the city to large populations of blacks, men who have sex with men and other high-risk groups (AP/Google.com, 8/27). According to the health department, it is unclear whether the number of new infections that occurred in the city in 2006 had increased or decreased over previous years because the testing method is new.

According to the study, men accounted for 76% of new HIV infections while women accounted for 25%. Blacks accounted for 46% of new infections, Hispanics for 32% and whites for 21%. Whites living in the city contracted HIV at four times the national rate, Hispanics at three times the national rate, and blacks in the city contracted the virus at almost twice the national rate. The study found that 4% of new infections were among people younger than age 20, while people ages 20 to 29 accounted for 24% of new infections. People ages 30 to 39 and those ages 40 to 49 each accounted for 29% of new infections, while people older than age 50 accounted for 15%. People younger than age 30 accounted for 28% of new infections in New York City, compared with 41% nationwide.

The primary mode of HIV transmission was sex between men, which accounted for 50% of new infections. High-risk heterosexual sex accounted for 22% of new infections, and injection drug use accounted for 8%. The mode of transmission was unknown in 18% of new cases, the study found (New York Times, 8/28).

In addition, the study found that blacks living in the city contracted HIV at three times the rate of whites and that blacks accounted for almost half of new infections (Reuters, 8/27). Of new HIV infections among MSM younger than age 30, 77% occurred in black and Hispanic men. Black and Hispanic MSM ages 30 to 50 also accounted for 59% of new infections among MSM in that age group (New York Times, 8/28).

Assistant Health Commissioner Monica Sweeney said the study's findings reinforce the need to continue promoting HIV testing and prevention throughout the city (AP/Google.com, 8/27). The department in a statement added that "even a rough gauge of HIV incidence is a valuable tool for understanding -- and combating -- the spread of HIV." The department said that by using the same testing method in future years, "researchers may be able to discern increases and decreases [in HIV incidence] over time and target prevention efforts accordingly" (New York Times, 8/28).

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Stamford, Conn., Officials Concerned About HIV/AIDS Among Hispanics
[Aug 26, 2008]

      HIV/AIDS advocates in Stamford, Conn., are expressing concern about HIV/AIDS cases among Hispanics and how to effectively target outreach efforts toward the community, the Stamford Advocate reports.

As of June, 118 Hispanics in Stamford were living with HIV/AIDS, according to the Stamford Health Department. Hispanics make up 22.3% of all current HIV/AIDS cases in the city and 19.7% of the population, according to estimates from the U.S. Census Bureau. In nearby Norwalk, Conn., Hispanics represent 18.6% of people living with HIV/AIDS and 24.3% of the population. Nationwide, Hispanics make up 18.9% of reported AIDS cases and 15% of the population, according to the Kaiser Family Foundation.

Debra Katz, director of Stamford's HIV prevention program, said that the figures are of concern because HIV/AIDS cases among Hispanics outpace their proportion of the population. Dennis Torres of Stamford Cares, a city agency that provides housing, financial and medical assistance to those living with HIV/AIDS, said, "I think nationally, the message hasn't reached this community."

Public health officials say that cultural beliefs, lack of health insurance and concerns about legal status are some of the barriers that prevent effective HIV/AIDS outreach to the Hispanic community, the Advocate reports. In addition, Hispanics' religious values and cultural taboos about discussing HIV/AIDS and sex have an effect on outreach, according to city health officials. Cedric Reid, a city HIV prevention worker, said Hispanic women are the most difficult to reach with sexual education outreach efforts because they are very modest.

Stamford health officials have made efforts to reach out to the Hispanic community by employing bilingual staff in HIV/AIDS prevention programs and conducting outreach efforts at churches and day laborer sites, Torres said. Torres added, "We help people if they have no food, if their lights are going to be shut off, all of the things that would keep people from getting medication," adding, "We remove all those barriers, because treatment is prevention" (Perez, Stamford Advocate, 8/24).

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Coalition of More Than 30 Groups Calls on Presidential Candidates To Develop National HIV/AIDS Strategy
[Aug 27, 2008]

      A coalition of more than 30 HIV/AIDS advocacy groups representing minority communities in the U.S. has called on presidential candidates Sens. John McCain (R-Ariz.) and Barack Obama (D-Ill.) to develop a comprehensive national strategy to fight HIV/AIDS, VOA News reports.

Ravinia Hayes-Cozier, director of government relations and public policy for the National Minority AIDS Council, said it is important for the next U.S. president to address HIV/AIDS in the country because "there has been silence on the domestic side about HIV/AIDS." She added that is "important" that people living in the U.S. "still see [HIV/AIDS] as an epidemic that is affecting people in this country, particularly minorities," and that the number of minorities living with HIV/AIDS in the U.S. "continue[s] to go up." Minorities account for about 65% of the estimated 56,000 new HIV infections annually in the U.S., according to VOA News.

The U.S. is "one of the very few countries" that does not have a national HIV/AIDS strategy, Hayes-Cozier said, adding that the U.S. is "at a point where we've had a great deal of experience with HIV/AIDS." She added that there are "some things that we know work well. There are some things we need to modify and change, and there are some things we just shouldn't be a part of."

According to Hayes-Cozier, a national strategy should include several elements aimed at fighting HIV/AIDS, starting with HIV prevention. The strategy's prevention component would "give consistent messages across the country that everyone supports," she said, adding that the plan would "provide a way of ongoing communication around HIV/AIDS" through education, health care and media. In addition, the plan would ensure "unified" HIV counseling and testing that provides "clear outcomes and expectations" that are not "just based on individual communities or states or cities," Hayes-Cozier said.

The treatment component of the plan would outline "strong protocols in how we implement care and treatment for those who are impacted by HIV/AIDS," according to Hayes-Cozier. The treatment component also would allow the community to look at HIV/AIDS from "a chronic disease perspective," develop "clear [treatment] guidelines" and increase efforts to reduce the spread of HIV/AIDS in communities most affected by the disease, according to Hayes-Cozier (DeCapua, VOA News, 8/26).

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Asian-American/Pacific Islanders Have Higher Survival Rates than Others for Gastric Cancers, Study Finds
[Aug 25, 2008]

      Asian-American/Pacific Islanders with early-stage stomach cancers have an overall median survival rate that is higher than those of other races or ethnicities, according to new research, Reuters Health reports.

For the study, Barry Feig of the University of Texas M.D. Anderson Cancer Center and colleagues examined more than 81,000 cases of gastric cancers from the National Cancer Database between 1995 and 2002. The researchers' sample was made up of 71.5% whites, 13.7% blacks, 7% Hispanics, 5.8% Asian-American/Pacific Islanders and 2% from other groups. The five-year relative survival rates for stage I and stage II stomach cancers in Asian-American/Pacific Islanders were about 77% and 48%, respectively, compared with 61% and 39% for Hispanics, 59% and 33% for whites, and 56% and 38% for blacks.

Researchers concluded that while there were "significant differences" in survival rates that favored Asian-American/Pacific Islanders, "Further studies should target underlying biologic and socioeconomic factors to explain these differences" (Reuters Health, 8/22).

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American Indian/Alaska Natives Have Significantly Higher Alcohol-Related Death Percentage Than General Population, CDC Reports
[Aug 29, 2008]

      Nearly 12% of American Indian and Alaska Native deaths over a four-year period were alcohol related, according to a CDC report released on Thursday, AP/USA Today reports. Researchers found after examining death certificates from 2001 to 2005 that 11.7% of deaths -- or 1,514 deaths -- among American Indians and Alaska Natives were alcohol-related. During the same time period, 3.3% of all deaths in the U.S. were related to alcohol. The report also found:

• Traffic accidents and liver disease are the two leading causes of alcohol-related deaths among American Indians and Alaska Natives;
  
  
• About one-third of alcohol- related deaths in the American Indian/Alaska Native population occurred in the Northern Plains, where reservations are remote and often destitute;
  
  
• Alaska had the lowest number of alcohol-related deaths among American Indians/Alaska Natives; and
  
  
• More than 68% of American Indian/Alaska Native alcohol-related deaths were among men, 66% were among those younger than age 50 and 7% were among those younger than age 20.
  

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Breastfeeding Could Reduce Risk of Aggressive Form of Breast Cancer That Disproportionately Affects Black, Younger Women
[Aug 26, 2008]

      Breastfeeding for at least six months might lower the risk of developing so-called "triple negative" breast cancer, an aggressive form of the disease that is more common in black and younger women, according to a study published on Monday in the journal Cancer, the Seattle Post-Intelligencer reports (Paulson, Seattle Post-Intelligencer, 8/24).

Nearly 50% of black women younger than age 55 who are diagnosed with breast cancer have the triple negative type, compared with 22% of white women. The five-year survival rate for triple negative breast cancer is 15% lower than for other types of the disease, in part because the disease responds poorly to most breast cancer treatments (Kaiser Health Disparities Report, 5/30).

To determine what puts women at risk for the triple negative type of breast cancer, lead researcher Amanda Phipps, a scientist in the public health division of the Fred Hutchinson Cancer Research Center, and colleagues studied two groups of women ages 55 to 79. One group was made up of 1,140 women who had several different forms of breast cancer, including the triple negative type, the most common "luminal" form and another form associated with the HER2 protein. The second group was made up of 1,476 women who had not been diagnosed with breast cancer.

Researchers took into account the participants' reproductive health histories, which would provide indicators of hormone levels over time, such as breastfeeding practices and the onset of menstruation and menopause.

Among other findings, researchers found that breastfeeding for at least six months corresponded with a lower risk of developing the triple-negative form of breast cancer and the common luminal form. It is not exactly clear why breastfeeding influenced hormonal cancer risks. Phipps said, "One possible explanation is that while women are breastfeeding, they aren't menstruating and so their hormones aren't cycling," so the longer women breastfeed, the less chance their hormones have to develop a cancer. Another theory is that breastfeeding alters the structure of breast cells in a way that makes them less prone to develop into cancer cells, Phipps said.

She said the findings indicate that reproductive behavior "helps explain why some women are at higher risk and also why certain therapies are not effective against these more aggressive forms of breast cancer" (Seattle Post-Intelligencer, 8/24).

An abstract of the study is available online.

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Exclusive Breastfeeding Increases Child's Risk for Vitamin D Deficiency; Black, Darker-Skinned Children Already Have Increased Risk
[Aug 27, 2008]

      Exclusive breastfeeding can increase a child's risk of developing rickets because breast milk alone does not provide adequate levels of vitamin D, a critical ingredient that helps to absorb calcium and build strong bones, the New York Times reports. Rickets develops when a child's vitamin D levels are too low and is characterized by the curving of a child's legs and the softening of other bones. Some children are asymptomatic.

Darker-skinned children have a greater risk of vitamin D deficiency than other children because they do not absorb vitamin D as easily through the skin. Sunlight enables the skin to synthesize vitamin D.

Cases of nutritional rickets among infants and young children in the U.S. have been "accumulating over the last decade or so," and children with the condition are more likely to be black or dark-skinned and have been breastfed exclusively for an extended period of time without vitamin supplementation, according to the Times. Some experts say that an increase in infants being exclusively breastfed, more children drinking soda or juice and less milk, and children spending less time in the sun could contribute to rickets re-emerging as a public health problem, the Times reports.

According to the Times, while physicians have known for years that exclusive breastfeeding is associated with vitamin D deficiency in infants and rickets, many are "reluctant to say anything that might discourage breastfeeding." The American Academy of Pediatrics in 2003 recommended that infants who are exclusively breastfed receive vitamin D drops daily.

According to one study on rickets and vitamin D that included mostly black and Hispanic infants and toddlers, 40% of the participants had low levels of vitamin D, 12% were vitamin D deficient, 13 children showed evidence of bone loss and three children had signs of rickets. The study, published in the June issue Archives of Pediatrics & Adolescent Medicine, also found that breastfeeding without vitamin supplementation was a significant risk factor for rickets.

Study author Catherine Gordon, director of Children's Hospital Boston's bone health program, said, "I completely support breastfeeding, and I think breast milk is the perfect food, and the healthiest way to nourish an infant. However, we're finding so many mothers are vitamin D deficient themselves that the milk is therefore deficient, so many babies can't keep their levels up." She added, "They may start their lives vitamin D deficient, and then all they're getting is vitamin D deficient breast milk" (Rabin, New York Times, 8/26).

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Kansas American Indian Tribe Declares Health Care Emergency, Requests Funds From IHS
[Aug 28, 2008]

      The Kickapoo American Indian tribe in Kansas has declared a health care emergency and has requested $150,000 from Indian Health Services, the AP/Kansas City Star reports (AP/Kansas City Star, 8/27). The request will allow the tribe to continue running its health clinic through the fiscal year ending Sept. 30, according to the Topeka Capital-Journal. The tribe has not yet received a response to its request, Josephine Bellonger, director of the clinic, said.

Bellonger noted that rising health care costs and an increasing number of patients using the tribe's clinic has caused a budget deficit. In addition, federal appropriations to the clinic this year were $200,000 below the amount the clinic received in 1992 when it opened. Eighty percent of the clinic's $1.5 million budget comes from federal sources, and the tribe contributes $300,000.

The Kickapoo's clinic serves 2,900 American Indians across Kansas and in southeast Nebraska. Forty percent of its patients are uninsured, according to the Capital-Journal.

Dianne Dawson, an IHS spokesperson, said the federal government has been struggling to meet the health care demands of American Indians and Alaskan natives. "There is an unmet need, obviously," she added.

Kickapoo Tribal Chair Steve Cadue, who is a delegate to the Democratic National Convention, said he plans to raise the issue at the convention in Denver. "Indian people are dying across this country from inadequate health care," he said, adding, "It seems as though they believe a certain number of Native American people are expendable" (Carpenter, Topeka Capital-Journal, 8/27).

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Minnesota Officials To Examine Autism in Somali Immigrant Children
[Aug 25, 2008]

      Minnesota health officials are examining a "possible surge" in autism cases among Somali immigrant children in the state, the Minneapolis Star Tribune reports. In Minneapolis, 3.6% of Somali immigrant students were in autism-related programs as of July, about twice the district average. In 2007, Somali children made up 6% of the city's school population and 14 of the 81 children, or 17%, in early childhood education autism programs in Minneapolis. The "numbers have been creeping up for several years, especially among young children," the Star Tribune reports.

Anne Harrington, a special education coordinator in the Minneapolis schools, said the number of Somali children in the city's autism programs jumped from zero in 1999 to 43 in 2007. The number of Somali-speaking children in the Minneapolis school district increased from 1,773 to 2,029 during the same period, data show.

Dan McLellan, a developmental pediatrician and autism specialist at Children's Hospital and Clinics of Minnesota, estimated that 10% of his patients are Somali, adding that the group appears to have a more severe form of the condition. Last year, 25% of Minneapolis students with the most severe cases of autism were Somali preschool-aged children, Harrington said.

State health officials are not yet able to explain the findings. Obtaining an accurate count of autism cases among Somalis is difficult because the range of symptoms for diagnosis has expanded, according to the Star Tribune. In addition, it is "especially tricky" to determine whether autism is increasing among Somali children because it is unknown if the condition is less common in Africa or better diagnosed in the U.S., according to the Star Tribune.

The Minnesota Department of Health has brought together a group of scientists who will investigate the issue. Judy Punyko, the official charged with leading the group, said, "The bottom line is that we don't have enough information."

Catherine Rice, head of a CDC autism monitoring program who will work with the Minnesota study group, said, "We know that more children are diagnosed today (than) in the past," adding, "A lot of it is the change in what we call autism. But we can't say that explains all of it." Rice said, "We certainly get indications that autism exists in other communities of the world, but whether it exists to the same degree, as common, it's not quite as clear" (Lerner, Minneapolis Star Tribune, 8/24).

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Ministers Encourage HIV Testing in New Orleans Black Churches
[Aug 26, 2008]

     Seven ministers in New Orleans on Sunday took HIV tests in front of their congregations totaling more than 2,000 people in an effort to confront the stigma associated with the virus in the black community, the New Orleans Times-Picayune reports.
HIV tests were offered immediately after most services at nearby locations or in the churches themselves. The Clergy Community HIV Testing Day Committee spearheaded the initiative in partnership with the HIV/AIDS Program of the Louisiana Office of Public Health and the NO/AIDS Task Force.

Joseph Merrill, minister of the New Kingdom Missionary Baptist Church, participated in the testing and said that HIV is "no longer a white man's disease," adding, "We've been silent, quiet, absent. We've ignored it. We've been afraid to mention it." According to the Times-Picayune, 63% of people newly diagnosed with HIV in the greater New Orleans area last year were black, with nearly 25% of new cases occurring among women. New Orleans was ranked eighth in the nation in 2006 for AIDS case rates per capita, and Baton Rouge was ranked fourth, the Times-Picayune reports (Reckdahl, New Orleans Times-Picayune, 8/25).

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Individuals Recognized for Health Awareness Efforts in the Black Community; Trust Fund Offers Grant to Reduce Health Disparities Between Blacks, Whites
[Aug 29, 2008]

      The following summarizes efforts and a grant that seek reduce racial health care disparities.

• Albany, N.Y.: The Albany Times Union on Aug. 23 profiled the Rev. Oscar McLaughlin, a local pastor and a chaplain at Hudson Correctional Facility and a local organizer for the national HIV/AIDS advocacy group The Balm in Gilead. McLaughlin, motivated by the high HIV/AIDS rates in the black community, organized a committee at his church that seeks to educate its members on HIV/AIDS and held its first health fair this summer, where 14 people were tested (Albany Times Union, 8/23).
  
  
• North Carolina: The North Carolina Health and Wellness Trust Fund over the next three years will award $7.5 million in grants to agencies and initiatives that seek to reduce health disparities between black and white residents, the Winston-Salem Chronicle reports. The trust fund last week began to accept applications from eligible organizations that have documented experience and success in developing and implementing services to reduce health disparities. Funds also are available for programs that aim to increase cultural competency among local health care providers and improve quality of services provided to minorities. Proposals and other application materials are available on the group's Web site and all applications must be received by Oct. 1 (Winston-Salem Chronicle, 8/27).
  
  
• Pittsburgh: Five women in the U.S. each have received a $5,000 Cheerios Sisters Saving Hearts grant from the Congressional Black Caucus and Cheerios for raising heart disease awareness among blacks, the Pittsburgh Post-Gazette reports (Pittsburgh Post-Gazette, 8/28). The initiative recognizes individuals for their awareness efforts in the black community. Heart disease is the leading cause of death among women in the U.S., and black women are disproportionately affected by the disease (Cheerios Sisters Saving Hearts Web site).
  
  

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New Orleans Ministers' HIV Testing Campaign Helps Address Stigma in Black Community, Editorial Says
[Aug 27, 2008]

      The seven New Orleans black ministers who participated in the Clergy Community HIV Testing Day earlier this week are "helping to remove the fear and stigma that prevents people from learning their HIV status," a New Orleans Times-Picayune editorial says. According to the editorial, the ministers broke "what they described as the black church's silence on HIV/AIDS" when they publically took HIV tests in front of their congregations and "urg[ed] congregants to do likewise." Sixty-three percent of the newly diagnosed HIV cases in New Orleans last year were among blacks, the editorial says. Early prevention is a "critical message, especially for" blacks, the editorial says, concluding that the ministers' "actions spoke volumes to a vulnerable population" (New Orleans Times-Picayune, 8/27).

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Event Date: 9/4/2008
Host: Northern New Jersey Maternal/Child Health Consortium and New Jersey Department of Health and Senior Services
Event: New Jersey's Ninth Annual Perinatal Health Disparities Conference, "Celebrating Minority and Multicultural Health Month"
Location: University of Medicine and Dentistry of New Jersey-Oral Health Pavilion
Event Contact: Renee Webster, 201-843-7400; or visit Web site.